Abstract
BackgroundTwo ipsilateral hemivertebrae is less common and presents severe growth imbalance caused by the vertebral anomalies. However, there is a paucity of reports regarding to two ipsilateral thoracolumbar hemivertebrae. The purpose of present study is to evaluate the long-term outcomes of the posterior surgical correction of thoraco-lumbar spine deformity caused by two ipsilateral hemivertebrae.MethodsFrom 2006 to 2014, a total of 14 consecutive pediatric patients with congenital thoraco-lumbar hemivertebrae were treated by posterior excision of hemivertebrae with short segment fusion. The following parameters were measured: coronal major curvature, cranial and caudal compensatory curvature, segmental kyphosis, lumbar lordosis, trunk shift, apical vertebra translation and sagittal vertical axis. These results were compared and evaluated in preoperatively, immediately postoperatively and at the final follow-up. All patients had a minimum of 5 years follow-up.ResultsThe mean age at surgery was 11.1 ± 4.8 years (2yos to 17yos). The mean follow-up period was 80.2 ± 19.4 months (60mons to 117mons). There was a mean improvement of 74.2% in the coronal major curve from a mean angle of 64.1° before surgery to 15.8° at the final follow-up. The cranial and caudal curves improved of 69.8 and 69.0% from 25.6° to 7.7°, 26.9 to 8.2, respectively. The mean thoraco-lumbar kyphosis was 59.9° before and 13.6° after surgery, 20.8° at the final follow-up. Alignment in the coronal and sagittal plane was either maintained or improved within normal values in all patients.ConclusionsGood correction and spinal balance can be achieved by posterior-only hemivertebrectomy in patients with thoracolumbar kyphocsoliosis caused by two ipsilateral hemivertebra. The complication of neurological injury is low but a technically demanding procedure. More attention should be paid in residual curve progression after surgery.
Highlights
Two ipsilateral hemivertebrae is less common and presents severe growth imbalance caused by the vertebral anomalies
The aim of this study is to evaluate the long-term outcomes of the one-stage posterior-only surgical correction of thoracolumbar kyphoscoliosis caused by two ipsilateral HV
From 2006 to 2014, we identified all patients with the diagnosis of congenital thoracolumbar kyphoscoliosis, among of these patients who had two ipsilateral HV were reviewed from our database
Summary
Two ipsilateral hemivertebrae is less common and presents severe growth imbalance caused by the vertebral anomalies. The purpose of present study is to evaluate the long-term outcomes of the posterior surgical correction of thoracolumbar spine deformity caused by two ipsilateral hemivertebrae. Hemivertebra (HV) is the most common cause of congenital scoliosis; especially when the HV is fully segmented or semi-segmented, progression of curve is usually unavoidable [3]. McMaster et al had reported the natural history of thoracolumbar HV in patients younger than 5 years old. They found that the main curve progression varied from 41° to 148° during a mean 4-years follow-up [1]. All of them require surgical treatment to achieve symmetric growth of the spine at the early stage, avoiding more serious spinal deformities
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
