Short fixation with a 3-rod technique for posterior hemivertebra resection in children younger than 5 years old.

Abstract

ABSTRACTImportanceCongenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation. However, implant‐related complications are common in children younger than 5 years old who undergo this surgical procedure.ObjectiveTo present the preliminary clinical and radiological outcomes of children younger than 5 years old treated by posterior hemivertebra resection and 3‐rod fixation technique.MethodsFrom January 2016 to December 2017, 14 consecutive patients of congenital scoliosis with 16 hemivertebrae were retrospectively reviewed, including 5 girls and 9 boys, aged between 25 and 55 months old (average, 37.6 months). All patients underwent posterior hemivertebra resection with short fixation with bilateral pedicle screws and a convex lamina hook. Surgical complications and corrective outcomes were assessed based on the clinical charts and spinal radiographs with a minimum 24‐month follow‐up.ResultsThe mean Cobb angle of the main curve was 38.4° before surgery, 8.5° after surgery, and 8.7° at final follow‐up. In the compensatory cranial curve, the preoperative Cobb angle of 16.8° was corrected to 8.1° postoperatively and was 10.3° at final follow‐up. In the compensatory caudal curve, the preoperative Cobb angle of 15.9° improved to 5.3° postoperatively and was 7.8° at final follow‐up. The segmental kyphosis was corrected from 13.5° to 0.5° and was 1.1° at final follow‐up. There were no crankshaft phenomena, no proximal kyphosis, and no complications related to the instrumentation.InterpretationPosterior hemivertebra resection with instrumentation with bilateral pedicle screws and a convex lamina hook can achieve rigid fixation and deformity correction.