Hemivertebra Resection in the Cervical Spine

Abstract

Study Design. 

Retrospective study with clinical and radiologic evaluation of hemivertebra resection in children with congenital cervical scoliosis.

Objective. 

Assessment of hemivertebra resection in the treatment of congenital cervical scoliosis.

Summary of Background Data. 

To our knowledge, this is the first report on hemivertebra resection in the midcervical spine.

Methods. 

Three patients with torticollis due to a cervical hemivertebra were operated on by hemivertebra resection and fusion of the adjacent vertebrae. Resection was performed by a posterior-anterior (-posterior) approach. Mean age at time of surgery was 9 years 3 months. They were retrospectively studied with a mean follow-up of 4.8 years.

Results. 

Mean segmental Cobb angle at the hemivertebra was 29° before surgery, 5° after surgery, and 6° at latest follow-up. Head tilt improved from 17° before surgery to 1° after surgery, and 3° at latest follow-up. Bony fusion was achieved in all cases. There was weakness of the left deltoid muscle in 1 case due to C5 root compression by a facet screw, which resolved completely after revision with change of the screw.

Conclusions. 

Resection of a cervical hemivertebra may be an option in the treatment of congenital cervical scoliosis. A good correction of the local deformity and a complete correction of head tilt are achieved. By early operation in young children, the development of severe secondary deformities in the upper thoracic spine can be avoided.

In Brief

Three hemivertebra resections were performed in the cervical spine with fusion of the adjacent vertebrae. An excellent correction of the local deformity and of the head tilt was achieved. There were no complications except for 1 C5 root lesion as the result of a facet screw placement, which resolved completely after revision with change of the screw.