There was completely segmented hemivertebra in 12 cases and partially segmented hemivertebra in 2 cases. Hemivertebra position: Hemivertebra was in thoracic vertebrae in 9 cases, in lumbar vertebrae in 3 cases, and in sacral vertebrae in 2 cases. The age of these patients ranged from 1 to 11.4 years, with an average of 3.7 ± 2.8 years.
All the pedicles were poorly developed on the opposite side of the hemivertebra. Group A: There were 7 males and 7 females in this group. According to the fixation method, the patients were divided into the unilateral internal fixation group (group A, 14 cases) and the bilateral internal fixation group (group B, 15 cases). Exclusion criteria included: (1) multiple hemivertebrae deformities (3) a previous history of spinal internal fixation (3) follow-up duration of <2 years and (4) clinical data missing or incomplete. The inclusion criteria included: (1) single hemivertebra deformity (2) Cobb angle greater than 30° or increased by 5° every year (3) no previous history of spinal internal fixation (4) follow-up duration of ≥2 years and (5) complete clinical data. In this study, 29 children with CS who underwent hemivertebra resection via the posterior approach and internal fixation from November 2005 to September 2018 were enrolled. Materials and Methods General Information This study was designed to compare the curative efficacy of hemivertebra resection via the posterior approach assisted with unilateral and bilateral internal fixation in the treatment of CS.
At present, a one-stage hemivertebra resection via the posterior approach combined with bilateral pedicle screw internal fixation as the treatment of CS is often reported ( 5– 8), but there are few studies on this treatment method including unilateral internal fixation. A hemivertebra resection via the anterior–posterior approach and via the posterior approach are commonly used due to these procedures' ability to directly remove teratogenic factors. Surgical treatment methods include in situ fusion, convex epiphyseal block, hemivertebra resection, and spinal fusion. CS deformity in children is complex and even serious at birth, and develops continuously with growth therefore, most scholars advocate early surgical treatment to block the progress of spinal deformity ( 3, 4). According to the relationship between hemivertebrae and upper and lower vertebrae, CS can be divided into three types: fully segmented hemivertebra, partially segmented hemivertebra, and non-segmented hemivertebra ( 1, 2). Hemivertebra is the most common type of vertebral development disorder, accounting for ~46% of cases. It is able to preserve a certain degree of contralateral spinal growth potential and is a feasible method.Ĭongenital scoliosis (CS) is a spinal deformity caused by abnormal vertebral growth in the 4th−6th weeks of fetal development. After the operation and at the last follow-up, the correction rates of kyphosis were 83.1 and 79.6% in group A and 71.8 and 65.5% in group B ( P > 0.05).Ĭonclusion: Hemivertebra resection via posterior approach with unilateral internal fixation can also achieve the effect of bilateral internal fixation in the treatment of CS. Results: In group A, the operation duration was 207.4 ± 54.5 min, and the bleeding volume was 215.3 ± 75.4 ml in group B, the operation duration was 249.5 ± 51.0 min, and the bleeding volume was 291.3 ± 115.6 ml ( P 0.05). The operation duration, bleeding volume, and complications during the operation, as well as the Cobb angles of scoliosis and kyphosis before and after the operation and at the last follow-up, were compared between the two groups. The patients in group A received unilateral internal fixation, and those in group B received bilateral internal fixation. The follow-up duration ranged from 2 to 12.3 years, with an average of 5.7 years. The age of these patients ranged from 0.9 to 15 years, with an average of 3.8 years. Methods: In this study, 29 children (15 males and 14 females), who underwent hemivertebra resection via the posterior approach and received internal fixation from November 2005 to September 2018, were analyzed retrospectively. Objective: This study aimed to compare the curative efficacy of hemivertebra resection via the posterior approach assisted with unilateral and bilateral internal fixation in the treatment of congenital scoliosis (CS). Department of Pediatric Orthopedics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.Jun-Ting He, Fu-Yun Liu *, Wei-Ming Hu, Jing-Jing Liu, Bing Xia, Xue-Qiang Niu, Xin-Wei Li and Yu-Feng Zhao