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The Efficacy of Hemivertebra Resection for Hemimetameric Segmental Shift
Qiunan Lyu1, Chunguang Zhou1, Yueming Song1
1Department of Orthopedics Surgery, West China Hospital, Sichuan University, Sichuan, China.
Background:
Hemimetameric segmental shift (HMMS) is defined as ≥2 contralateral hemivertebrae (HV) that are separated by at least 1 normal vertebra. Theoretically, the 2 HV tend to balance each other to produce minor spine deformities. However, curve progression has still been observed in HMMS. No research has yet specifically studied its surgical treatment. This study aimed to report efficacy of HV resection for HMMS.
Methods:
From 2009 to 2015, 15 patients (5 male and 10 female) with HMMS underwent HV resection in our department. Average age at the time of surgery was 10.5 ± 4.7 years, and mean length of follow-up was 38.5 ± 7.1 months. Clinical outcomes and related complications were assessed by reviewing the medical records, operative notes, radiographic data, and scores on the Scoliosis Research Society-22 questionnaire.
Results:
The segmental curve was 45.1° ± 10.6° preoperatively, 14.3° ± 7.8° postoperatively, and 15.3° ± 7.6° at the latest follow-up. The cranial compensatory curve was 17.1° ± 11.9°, 8.9° ± 6.3°, and 7.8° ± 6.5°. The caudal compensatory curve was 12.0° ± 11.0°, 4.5° ± 4.8°, and 4.3° ± 5.0°. Spinal balance was significantly improved in both coronal and sagittal planes and remained stable until the latest follow-up. Three domains of the Scoliosis Research Society-22 questionnaire, including general self-image, mental health, and satisfaction, were significantly improved at the latest follow-up compared with preoperative status.
Conclusions:
HV resection is a safe and effective treatment for HMMS that causes progressive or severe deformity.
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