Posterior-only lumbosacral hemivertebrae resection and fusion in paediatric scoliosis with minimum twoyear follow-up.

Abstract

To evaluate the clinical and radiological outcomes for patients who undergone posterior-only lumbosacral hemivertebrectomy with short fusion with minimum twoyear follow-up. From 2005 to 2016, a consecutive series of 16 paediatrics scoliosis due to lumbosacral hemivertebrae were included in this study. They were treated by one stage posterior hemivertebrae resection with bilateral or unilateral short fusion. Coronal and sagittal parameters and pelvic obliquity were measured at pre-operatively, immediate post-operatively and at final follow-up. The outcome and efficacy of the correction were investigated. The mean age was 10.4 ± 3.4years (3-15years). The mean follow-up period was 38.8 ± 16.2months (24-79months). The mean segmental scoliosis was 35.4 ± 9.2 and 7.7 ± 5.4 pre-operatively and post-operatively (78.4% correction rate) and 8.2 ± 5.0 (77%) at the latest follow-up. The compensatory coronal curve of 28.6 ± 16.1 was spontaneously corrected to 8.0 ± 8.4 in post-operatively 12.0 ± 8.4 at final follow-up. Trunk shift was significantly improved on both coronal (RTS 86.1%) and sagittal plane (68.7%) after the surgery and kept stable during the follow-up. Sacral tilt of 14.2 ± 5.3 was significantly improved to 4.7 ± 3.6 at final follow-up. There was no significant difference between bilateral and unilateral instrumentation groups (P > 0.05). One case had implants failure, and the incidence rate is 6.3%. Early posterior hemivertebrectomy with short fusion is effective in the treatment of lumbosacral hemivertebrae. It can achieve good coronal curve correction, sacral tilt, and trunk shift improvement. No neurological complications were found. Importantly, it can prevent secondary structural deformities and potentially save fusion level.