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
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.
