Posterior hemivertebrectomy and short segment fixation-long term results.
OBJECTIVES
The objectives of this study were to study the long-term results of one-stage single and multiple level posterior hemivertebrectomies and to find out the safety and efficacy of the procedure.


METHOD
Twenty patients (9 male and 11 female) with mean age of 9.2 years (2 years 4 months-14 years 10 months) with congenital scoliosis (hemivertebrae) were treated with posterior hemivertebrectomy with intraoperative neuromonitoring. Posterior exposure and transpedicular fixation of the adjoining vertebrae was done. The hemivertebra was approached from the convex side, and transpedicular decancellation followed by complete excision was done. Controlled compression at the convexity was done after a cantilever manoeuvre was done for rod capturing on the convexity to achieve the reduction.


RESULTS
Average number of hemivertebra removed was 1.46 (1-3). Mean pre-op and post-op coronal Cobb angle was 48.8° (range 22 to 80) and 24.2° (range 7 to 41), respectively (p < 0.001). Mean pre-op and post-op sagittal Cobb angle was 32.1° (range 7 to 76) and 13.6° (range 0 to 23) respectively, (p < 0.005). Mean coronal and sagittal Cobb correction percentage achieved was 50.2 and 51.8%, respectively. Mean follow-up was 62.4 months (range 24-73 months). Mean loss of coronal and sagittal correction at final follow-up was 2.26° (0-8) and 1.55° (0-5), respectively. Maximum correction in both coronal (p = 0.167) and sagittal (p = 0.095) planes was achieved in thoracolumbar vertebrae. Maximum correction was achieved in 3 level hemivertebrae in sagittal (p = 0.9) and 2 level hemivertebrae in coronal plane (p = 0.740).


CONCLUSIONS
Posterior hemivertebrectomy is a safe and effective procedure for congenital scoliosis. Not only single but up to 3 level hemivertebrae can be safely removed with good correction of deformity. Long-term follow-up reveals good maintenance of correction.
['Basu|Saumyajit|S|http://orcid.org/0000-0001-7979-8745', 'Tikoo|Agnivesh|A|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D005260:Female D007839:Functional Laterality D006801:Humans D008137:Longitudinal Studies D008279:Magnetic Resonance Imaging D008297:Male D010027:Osteotomy D012600:Scoliosis D013123:Spinal Fusion D013904:Thoracic Vertebrae D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
Short segment Congenital Scoliosis Hemivertebra Early onset scoliosis Hemiverterectomy Spinal fusion