Background Patients with congenital scoliosis often also have intraspinal abnormalities and other organ defects, and few studies of the effects of congenital scoliosis on cardiac function and structure have been publi...Background Patients with congenital scoliosis often also have intraspinal abnormalities and other organ defects, and few studies of the effects of congenital scoliosis on cardiac function and structure have been published. Methods A total of 215 adolescent patients with congenital scoliosis （average age, 13.58 years） underwent preoperative echocardiography and were then assigned to subgroups according to apex vertebral rotation, side of convexity, curvature severity in the coronal and sagittal planes, type of deformity, and sex. Differences between the subgroups were compared by independent-samples ttest or a one-factor analysis of variance. Results We observed statistically significant differences between patients with right-sided scoliosis curvature and those with left-sided scoliosis curvature, respectively, in left ventricular inner diameter at end-diastole （（39.39±4.66）mm vs （41.74±4.90）mm）, left ventricular inner diameter at end-systole （（24.80±3.45）mm vs （25.92±3.07）mm）, interventricular septum thickness at end-diastole （（5.66±0.98）mm vs （5.98±1.03）mm）, and posterior wall of left ventricle at end-diastole （（5.61±0.98）mm vs （6.06±1.20）mm）. When the patients were evaluated by coronal plane Cobb angle, significant differences were found between those with Cobb angle of 40°-80° and of 〉80° in left ventricular inner diameter at end-diastole （（40.97±5.06）mm vs （38.98±4.45）mm） and left ventricular inner diameter at end-systole （（25.53±3.39）mm vs （24.36±3.14）mm）, respectively. When the patients were evaluated by sagittal plane Cobb angle （〈20°, group 1; 20°-40°, group 2; 〉40°, group 3）, significant differences were found in right ventricular diameter between those with Cobb angle of 〈20° and of 20°-40° （（18.27±3.66）mm vs （16.54±3.57）mm） and in diameter of aortic root between those with Cobb angle of 20°-40° and of 〉40° （（23.83±3.39）mm vs （24.90±3.30）mm）, respectively. No significant differences were found in ejection fraction and fractional shortening between patients according to apex vertebral rotation, side of convexity, coronal plane and sagittal plane Cobb angles, type of deformity, or sex. Conclusions Congenital scoliosis influences cardiac structure, but not function.展开更多
Objective To evaluate the efficacy of simultaneous anterior and posterior hemivertebra resection in the treatment of congenital kyphoscoliosis caused by fully-segmented hemivertebra. Methods Twenty-one consecutive ca...Objective To evaluate the efficacy of simultaneous anterior and posterior hemivertebra resection in the treatment of congenital kyphoscoliosis caused by fully-segmented hemivertebra. Methods Twenty-one consecutive cases with congenital kyphoscoliosis, which were 8 males and 13 females, underwent one-stage operation of anterior hemivertebra resection and posterior instrumentation. All of the hemivertebra were fully-segmented. The average age at surgery was 11.4 （range, 1.5-16） years old. Results The average follow-up was 23 （range, 6-50） months. The average Cobb＇s angle of the coronal curve was 51.4° （30°-120°） before surgery, 16.9° （0°-54°） after surgery, and 19.5° at latest follow-up. The angle of segmental kyphosis was 37.1° （0°-95°） before surgery and 16.1° （0°-48°） after surgery, and 18.2° at latest follow-up. Apical translation was improved from 4.7 cm to 1.9 cm. The average fusion segments were 4.8 （range, 2-10） segments. Complication included pressure sore in one case, pedicle cutting by pedicle screw in one case and elongation of the curve in one case. There was no obvious pseudarthrosis, decompensation, and kyohosis deformity aggravation at latest follow-up. Conclusion One-stage hemivortebra resection has a good result in the surgical treatment of congenital kyphoscoliosis caused by fully-segmented hemivertebra, and may shorten fusion levels if performed at an earlier age.展开更多
Congenital scoliosis results from defects formed during the embryologic development of the spinal vertebrae. Hemivertebra is a failure of vertebral formation carrying a risk of causing progressive scoliosis if it is ...Congenital scoliosis results from defects formed during the embryologic development of the spinal vertebrae. Hemivertebra is a failure of vertebral formation carrying a risk of causing progressive scoliosis if it is fully segmented. When two hemivertebrae are present on the opposite sides of the spine and are separated by at least one normal vertebra, this condition then exemplifies a hemimetameric shift. The hemimetameric shift is often benign for progression, but it may also be problematic depending on the separation and the nature of the two hemivertebrae involved. If the two opposing hemivertebrae are close merely separated by one or two normal vertebrae, they tend to cause two small kinks in the spine and minimal cosmetic deformity. However, if the two hemivertebrae are in different regions of the spine, separate curves are then produced and the spine may become unbalanced, causing spinal decompensation and significant cosmetic deformity. In this article, we report one case for whom a hemimetameric shift was managed via a one-stage posterior hemivertebral resection.展开更多
Importance Congenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation.However,implant‐related complications are common in children younger than 5 years ol...Importance Congenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation.However,implant‐related complications are common in children younger than 5 years old who undergo this surgical procedure.Objective To present the preliminary clinical and radiological outcomes of children younger than 5 years old treated by posterior hemivertebra resection and 3‐rod fixation technique.Methods From January 2016 to December 2017,14 consecutive patients of congenital scoliosis with 16 hemivertebrae were retrospectively reviewed,including 5 girls and 9 boys,aged between 25 and 55 months old(average,37.6 months).All patients underwent posterior hemivertebra resection with short fixation with bilateral pedicle screws and a convex lamina hook.Surgical complications and corrective outcomes were assessed based on the clinical charts and spinal radiographs with a minimum 24‐month follow‐up.Results The mean Cobb angle of the main curve was 38.4°before surgery,8.5°after surgery,and 8.7°at final follow‐up.In the compensatory cranial curve,the preoperative Cobb angle of 16.8°was corrected to 8.1°postoperatively and was 10.3°at final follow‐up.In the compensatory caudal curve,the preoperative Cobb angle of 15.9°improved to 5.3°postoperatively and was 7.8°at final follow‐up.The segmental kyphosis was corrected from 13.5°to 0.5°and was 1.1°at final follow‐up.There were no crankshaft phenomena,no proximal kyphosis,and no complications related to the instrumentation.Interpretation Posterior hemivertebra resection with instrumentation with bilateral pedicle screws and a convex lamina hook can achieve rigid fixation and deformity correction.展开更多
文摘Background Patients with congenital scoliosis often also have intraspinal abnormalities and other organ defects, and few studies of the effects of congenital scoliosis on cardiac function and structure have been published. Methods A total of 215 adolescent patients with congenital scoliosis （average age, 13.58 years） underwent preoperative echocardiography and were then assigned to subgroups according to apex vertebral rotation, side of convexity, curvature severity in the coronal and sagittal planes, type of deformity, and sex. Differences between the subgroups were compared by independent-samples ttest or a one-factor analysis of variance. Results We observed statistically significant differences between patients with right-sided scoliosis curvature and those with left-sided scoliosis curvature, respectively, in left ventricular inner diameter at end-diastole （（39.39±4.66）mm vs （41.74±4.90）mm）, left ventricular inner diameter at end-systole （（24.80±3.45）mm vs （25.92±3.07）mm）, interventricular septum thickness at end-diastole （（5.66±0.98）mm vs （5.98±1.03）mm）, and posterior wall of left ventricle at end-diastole （（5.61±0.98）mm vs （6.06±1.20）mm）. When the patients were evaluated by coronal plane Cobb angle, significant differences were found between those with Cobb angle of 40°-80° and of 〉80° in left ventricular inner diameter at end-diastole （（40.97±5.06）mm vs （38.98±4.45）mm） and left ventricular inner diameter at end-systole （（25.53±3.39）mm vs （24.36±3.14）mm）, respectively. When the patients were evaluated by sagittal plane Cobb angle （〈20°, group 1; 20°-40°, group 2; 〉40°, group 3）, significant differences were found in right ventricular diameter between those with Cobb angle of 〈20° and of 20°-40° （（18.27±3.66）mm vs （16.54±3.57）mm） and in diameter of aortic root between those with Cobb angle of 20°-40° and of 〉40° （（23.83±3.39）mm vs （24.90±3.30）mm）, respectively. No significant differences were found in ejection fraction and fractional shortening between patients according to apex vertebral rotation, side of convexity, coronal plane and sagittal plane Cobb angles, type of deformity, or sex. Conclusions Congenital scoliosis influences cardiac structure, but not function.
文摘Objective To evaluate the efficacy of simultaneous anterior and posterior hemivertebra resection in the treatment of congenital kyphoscoliosis caused by fully-segmented hemivertebra. Methods Twenty-one consecutive cases with congenital kyphoscoliosis, which were 8 males and 13 females, underwent one-stage operation of anterior hemivertebra resection and posterior instrumentation. All of the hemivertebra were fully-segmented. The average age at surgery was 11.4 （range, 1.5-16） years old. Results The average follow-up was 23 （range, 6-50） months. The average Cobb＇s angle of the coronal curve was 51.4° （30°-120°） before surgery, 16.9° （0°-54°） after surgery, and 19.5° at latest follow-up. The angle of segmental kyphosis was 37.1° （0°-95°） before surgery and 16.1° （0°-48°） after surgery, and 18.2° at latest follow-up. Apical translation was improved from 4.7 cm to 1.9 cm. The average fusion segments were 4.8 （range, 2-10） segments. Complication included pressure sore in one case, pedicle cutting by pedicle screw in one case and elongation of the curve in one case. There was no obvious pseudarthrosis, decompensation, and kyohosis deformity aggravation at latest follow-up. Conclusion One-stage hemivortebra resection has a good result in the surgical treatment of congenital kyphoscoliosis caused by fully-segmented hemivertebra, and may shorten fusion levels if performed at an earlier age.
文摘Congenital scoliosis results from defects formed during the embryologic development of the spinal vertebrae. Hemivertebra is a failure of vertebral formation carrying a risk of causing progressive scoliosis if it is fully segmented. When two hemivertebrae are present on the opposite sides of the spine and are separated by at least one normal vertebra, this condition then exemplifies a hemimetameric shift. The hemimetameric shift is often benign for progression, but it may also be problematic depending on the separation and the nature of the two hemivertebrae involved. If the two opposing hemivertebrae are close merely separated by one or two normal vertebrae, they tend to cause two small kinks in the spine and minimal cosmetic deformity. However, if the two hemivertebrae are in different regions of the spine, separate curves are then produced and the spine may become unbalanced, causing spinal decompensation and significant cosmetic deformity. In this article, we report one case for whom a hemimetameric shift was managed via a one-stage posterior hemivertebral resection.
文摘Importance Congenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation.However,implant‐related complications are common in children younger than 5 years old who undergo this surgical procedure.Objective To present the preliminary clinical and radiological outcomes of children younger than 5 years old treated by posterior hemivertebra resection and 3‐rod fixation technique.Methods From January 2016 to December 2017,14 consecutive patients of congenital scoliosis with 16 hemivertebrae were retrospectively reviewed,including 5 girls and 9 boys,aged between 25 and 55 months old(average,37.6 months).All patients underwent posterior hemivertebra resection with short fixation with bilateral pedicle screws and a convex lamina hook.Surgical complications and corrective outcomes were assessed based on the clinical charts and spinal radiographs with a minimum 24‐month follow‐up.Results The mean Cobb angle of the main curve was 38.4°before surgery,8.5°after surgery,and 8.7°at final follow‐up.In the compensatory cranial curve,the preoperative Cobb angle of 16.8°was corrected to 8.1°postoperatively and was 10.3°at final follow‐up.In the compensatory caudal curve,the preoperative Cobb angle of 15.9°improved to 5.3°postoperatively and was 7.8°at final follow‐up.The segmental kyphosis was corrected from 13.5°to 0.5°and was 1.1°at final follow‐up.There were no crankshaft phenomena,no proximal kyphosis,and no complications related to the instrumentation.Interpretation Posterior hemivertebra resection with instrumentation with bilateral pedicle screws and a convex lamina hook can achieve rigid fixation and deformity correction.
