Early outcome of one-stage posterior transpedicular hemi-vertebra resection in the treatment of children with congenital scoliosis / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the early outcomes of children with congenital scoliosis treated by one-stage transpedicular hemi-vertebra resection.</p><p><b>METHODS</b>From July 2005 to June 2006, 27 consecutive cases of congenital scoliosis managed by one-stage transpedicular hemi-vertebra resection with instrumentation were investigated retrospectively. There were 11 girls and 16 boys, with a mean age of 5.5 years at surgery (range 1.3 - 10.0 years). Location of the hemi-vertebra was in the thoracic spine in 12 cases and in the lumbar spine in 15 cases. Radiographic evaluations were performed on the preoperative, postoperative, and latest follow-up standing posteroanterior and lateral radiographs.</p><p><b>RESULTS</b>The average operation time was 4 hours (range 3-6 hours), and the mean blood loss during operation was 750 ml (range 300 - 2200 ml). The mean fusion level was 2 to 7 segments, average 4.4 segments. The average follow-up period was 16 months (range 12 - 34 months). Mean Cobb angle of the total main curve was 40.0° before surgery, 12.6° after surgery, and 15.2° at latest follow-up. Mean Cobb angle of the segmental main curve was 35.6° before surgery, 11.6° after surgery, and 12.1° at latest follow-up. The trunk shift was improved from 16.5 mm before operation to that of 7.5 mm after the operation and 7.6 mm at the latest follow-up. Compensatory cranial curve improved from 19.4° before surgery to 8.9° after surgery, and compensatory caudal curve improved from 26.3° to 12.8°. The angle of segmental kyphosis was 26.4° before surgery and 14.6° after surgery in cases with thoracic hemivertebrae, and averaged 11.2° before surgery and 3.9° after surgery in cases with lumbar hemivertebrae. Peri-operative complications included two pedicle screws malpositioning and one case with pelvic tilt. There was no neurological complication.</p><p><b>CONCLUSION</b>One-stage transpedicular hemi-vertebra resection with instrumentation has a good capability of correcting deformity on the frontal and sagittal planes, which is available in children with middle or lower thoracic or lumbar hemivertebrae.</p>