Abstract
BackgroundPrevious studies have reported favorable short-term outcomes after posterior-only hemivertebra resection and short fusion in patients with LSHV. However, there is a paucity of data evaluating the long-term outcomes following this procedure. The aim of the study is to evaluate the radiological outcomes following posterior-only hemivertebra resection and short fusion for the treatment of congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) with a minimum of a 5-year follow-up.MethodsA total of 23 patients treated with one-stage posterior-only LSHV resection and short fusion with a minimum of a 5-year follow-up were reviewed. Radiographic parameters including the Cobb angles of the lumbosacral curve and compensatory curve, the upper instrumented vertebra (UIV) tilt, and trunk shift were measured. The complications were recorded accordingly.ResultsThe mean duration of follow-up was 88.6 ± 28.5 months, and the average age at surgery was 7.8 ± 3.5 years. Fusion levels averaged 3.0 ± 0.7 segments. The lumbosacral curve was corrected from 30.7 ± 10.4° to 6.7 ± 7.1° after surgery (P < 0.001), 7.3 ± 6.1° 2 years after surgery, and 8.1 ± 7.0° at the last follow-up. The compensatory curve was spontaneously corrected from 23.7 ± 9.4° before surgery to 8.3 ± 5.2° after surgery (P < 0.001). However, the angle slightly increased to 9.0 ± 4.8° 2 years after surgery and to 9.6 ± 6.4° at the last follow-up. Trunk shift was improved from 27.3 ± 8.6 mm before surgery to 11.7 ± 9.4 mm after surgery, and it decreased to 10.8 ± 8.2 mm 2 years after surgery and 10.4 ± 8.8 mm at the last follow-up. One patient experienced transient neurologic deficits after surgery. One patient was observed to have screw loosening at 1-year follow-up and received revision surgery.ConclusionOne-stage posterior-only hemivertebra resection with short fusion is an effective procedure for LSHV, and the correction can be well maintained during longitudinal follow-up. Great attention should be paid to the restoration of lumbosacral horizontalization.
Highlights
Congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) is a complicated spinal deformity in young children and adolescents [1,2,3,4,5,6]
One-stage posterior-only hemivertebra resection with short fusion is an effective procedure for LSHV, and the correction can be well maintained during longitudinal follow-up
Short segmental fusion associated with posterior-only hemivertebra resection, due to its minimized side effects in terms of spine growth and mobility, has drawn the attention of spine surgeons [7, 12, 13]
Summary
Congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) is a complicated spinal deformity in young children and adolescents [1,2,3,4,5,6]. Hemivertebra located in this region frequently results in significant coronal decompensation and a long compensatory curve above, which is reported to progress approximately 1° to 3° per year if not treated [1, 3, 4]. LSHV resection with instrumentation and fusion was performed via one-/two-stage combined anterior and posterior approaches [7–11]. Short segmental fusion associated with posterior-only hemivertebra resection, due to its minimized side effects in terms of spine growth and mobility, has drawn the attention of spine surgeons [7, 12, 13]. Previous studies have reported favorable short-term outcomes after posterior-only hemivertebra resection and short fusion in patients with LSHV. The aim of the study is to evaluate the radiological outcomes following posterior-only hemivertebra resection and short fusion for the treatment of congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) with a minimum of a 5-year follow-up
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