ABSTRACT
Objective:
To investigate the
clinical efficacy and precautions of O-
arm combined with navigation-assisted steotomy and hemivertebra resection for
congenital cervicothoracic hemivertebra.
Methods:
From February 2016 to October 2020, the clinical data of 12
patients with cervicothoracic hemivertebra admitted in Henan Provincial People's
Hospital were retrospectively analyzed, including 5
males and 7
females,
aged 9.4±2.6 years (range, 4-15 years). Intraoperative neural
monitoring system was used to ensure the
safety of surgical correction process and O-
arm navigation system assisted the implantation of
pedicle screws,hemivertebra resection, and
scoliosis deformity correction. Postoperative CT was used to evaluate the accuracy of screw placement, and routine preoperative and postoperative
X-ray films of the full-length
spine in
standing position were taken to
measure the coronal and sagittal Cobb angles. The correction rate of
scoliosis and
kyphosis, internal fixation,
shoulder height difference and
bone graft fusion were calculated at the final follow-up.
Results:
A total of 108
pedicle screws were inserted in 12
patients, and the screw placement accuracy rate was 96.3% (104/108). The follow-up
time was 37.9±10.2 months (range, 24-61 months). The number of fused segments was 5.4±1.1 (range, 4-7). One week after
surgery, the correction rate of Cobb angle was 78.5%±3.2% for
scoliosis and 70.1%±5.4% for
kyphosis. There were statistically significant differences in side and
kyphosis Angle and
Scoliosis Research Society (SRS)-22 score between preoperative and 1 week after
surgery ( P<0.05). There was no significant difference between the operation and the last follow-up ( P>0.05). At the last follow-up, all the 12
patients achieved gradeⅠ fusion. SI was 2.4±0.8 cm before operation, 1.0±0.6 cm at 1 week after operation, and 0.7±0.5 cm at last follow-up, and the difference was statistically significant ( F=38.30, P<0.001). No pseudojoint formation, significant loss of correction Angle, or
rupture of internal fixation relaxant occurred during the operation or during follow-up.
Conclusion:
O-
arm combined with navigation-assisted steotomy and hemivertebra resection for the
treatment of
congenital cervicothoracic hemivertebra has the advantages of good orthopedic effect, reduced
radiation exposure and fewer
complications, and accurate
pedicle screw implantation and hemivertebra resection.