Posterior hemivertebrectomy and short segment fixation-long term results

Area of Science:

• Spine surgery
• Pediatric orthopedics
• Skeletal deformities

Background:

• Congenital scoliosis, often caused by hemivertebrae, presents significant spinal deformity challenges in pediatric patients.
• Surgical correction is frequently necessary to address progressive spinal curvature and prevent long-term complications.

Purpose of the Study:

• To evaluate the long-term outcomes, safety, and efficacy of one-stage posterior hemivertebrectomy for congenital scoliosis.
• To assess the procedure's effectiveness in correcting single and multiple-level hemivertebrae.

Main Methods:

• Twenty pediatric patients with congenital scoliosis underwent posterior hemivertebrectomy with intraoperative neuromonitoring.
• The surgical technique involved posterior exposure, transpedicular fixation, hemivertebra excision from the convex side, and corrective maneuvers.

Main Results:

• Significant improvements in both coronal (48.8° to 24.2°) and sagittal (32.1° to 13.6°) Cobb angles were observed (p < 0.001).
• Average correction percentages were 50.2% for coronal and 51.8% for sagittal deformities, with good maintenance at a mean 62.4-month follow-up.
• The procedure demonstrated safety and effectiveness, even for removing up to three hemivertebrae.

Conclusions:

• Posterior hemivertebrectomy is a safe and effective surgical option for pediatric congenital scoliosis.
• The procedure provides substantial and durable correction of spinal deformity, including complex multi-level hemivertebrae.
• Long-term follow-up confirms the sustained efficacy of posterior hemivertebrectomy in managing congenital scoliosis.