Hemivertebra Resection for the Treatment of Congenital Lumbarspinal Scoliosis With Lateral-Posterior Approach

Abstract

Study Design. 

A retrospective review of patient records was conducted.

Objective. 

To evaluate the results of a lumbar hemivertebra resection and short-segment fusion through a lateral-posterior approach.

Summary of Background Data. 

Few reports have been reported describing a procedure consisting of one-stage lateral-posterior lumbar hemivertebra resection and correction of the deformity by segmental anterior instrumentation to date.

Methods. 

From 1998 to 2006, a consecutive series of twenty-four patients with congenital scoliosis or kyphoscoliosis due to a lumbar hemivertebra were managed by resection of the hemivertebra through a lateral-posterior approach and with the use of a short anterior convex-side fusion.

Results. 

The mean age at the time of surgery was 9.4 years (range, 6 years and 8 months–16 years and 9 months). The mean follow-up period was 43 months (5–94). There was a mean improvement of 61.5% in the segmental scoliosis curve from a mean angle of 45.2° before surgery to 17.4° at the time of the latest follow-up assessment, and a mean improvement of 60.9% in the total main scoliosis curve from 47.6° to 18.6° at the same periods. The mean final lordosis was within normal values. There were no major complications and no neurologic damage.

Conclusion. 

Excision of a lumbar hemivertebra through lateral-posterior approach is safe and provides stable correction when combined with a short-segment fusion.

In Brief

Complete single hemivertebra excision carried out through a lateral-posterior approach is quite safe for lumbar regions of vertebral column. High correction and fusion rates can be achieved with short anterior segmental instrumentation. Minimal correction loss is observed at follow-up visits. Sagittal contours may be brought within normal physiologic ranges.