Abstract
PurposeHemivertebra is one of the common pathogenesis of congenital scoliosis. The timing of operation is undefined. Our study compared the surgical outcomes in children under age 10 years with scoliosis due to single nonincarcerated thoracolumbar hemivertebra according to the age at surgery.MethodsFrom January 2009 to August 2017, we retrospectively investigated 34 consecutive cases of congenital scoliosis treated by posterior hemivertebra resection and fusion with pedicle screw fixation. All cases were divided into two groups according to the age at surgery and followed-up for at least 2 years, group 1 (≤ 5 years old), and group 2 (5 to 10 years old).ResultsThe mean Cobb angle of the main curve was improved from 48.58° to 15.53° (68.05%) in group 1, and from 43.73° to 11.33° (75.43%) in group 2. The segmental curve was improved from 44.16° to 11.53° (74.64%) in group 1, and the segmental curve was consistent with the main curve in group 2. The mean segmental kyphosis was improved from 27.50° to 8.42° (67.40%) in group 1, and from 29.00° to 5.00° (84.73%) in group 2. Five patients developed distal adding-on, and four patients were found proximal junctional kyphosis during the follow-up.ConclusionNot all the deformities caused by single nonincarcerated thoracolumbar hemivertebra would progress greatly with the spinal growth. No significant statistical differences were found in the coronal and sagittal correction rate between the two groups. A limited delayed surgery after 5 years but before 10 years of age with close follow-up can achieve satisfied results.
Highlights
Hemivertebra is one of the common pathogenesis of congenital scoliosis especially in early onset scoliosis, and it is difficult to predict the prognosis
There are no reports in the literature regarding surgical outcomes by the age at the time of surgery in children under age 10 years with congenital scoliosis caused by a certain type of hemivertebra
All the patients were diagnosed as scoliosis due to single nonincarcerated thoracolumbar hemivertebra, we found that the preoperative coronal main curve, segmental curve and caudal compensatory curve in the group 1 were slightly larger than that in the group 2, and the cranial compensatory curve and segmental kyphosis were larger in the group 2 than in the group 1, but the difference between the two groups were not statistically
Summary
Hemivertebra is one of the common pathogenesis of congenital scoliosis especially in early onset scoliosis, and it is difficult to predict the prognosis. Surgery in young children prevents the development of severe local deformities and secondary structural curves, allowing for normal growth in the unaffected parts of the spine [5], while the timing of operation is undefined, there are reports in the literature that achieved good result in children under age 10 years with congenital scoliosis [6,7,8], in those before 5 years old [9, 10]. There are no reports in the literature regarding surgical outcomes by the age at the time of surgery in children under age 10 years with congenital scoliosis caused by a certain type of hemivertebra. The purpose of this study is to compare the surgical outcomes in children under age 10 years with scoliosis due to single nonincarcerated thoracolumbar hemivertebra undergoing posterior hemivertebra resection and fusion with pedicle screw fixation
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