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Erschienen in:
01.06.2015 | Original Paper
A modified surgical procedure for congenital kyphoscoliosis: selective partial hemivertebrectomy via posterior-only approach
Erschienen in: Child's Nervous System | Ausgabe 6/2015
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Objectives
The study aims to assess the correction efficacy of selective partial hemivertebra excision via posterior-only approach for adolescent patients with congenital kyphoscoliosis.
Methods
A total of 17 cases (10 M/7 F) were enrolled to this study, all of whom were fully segmented hemivertebra. The mean grade of Risser sign was 1.82 ± 1.07. The average time of follow-up was 20.12 ± 6.88 months. Patients were all treated with selective partial hemivertebra excision and instrumentation via posterior-only approach. The maximal coronal Cobb angle, segmental curves, and segmental kyphotic curves are measured before and after operation, and at the latest follow-up. The data was analyzed to evaluate the correction efficacy.
Results
There were no postoperative infections and no neurological complications in all patients. The mean size of the segmental curve was 38.65 ± 5.35° before operation and 13.55 ± 1.82° after operation, with a mean correction of 25.10 ± 5.44°, which turned to 16.59 ± 2.14° at latest follow-up. The mean maximal coronal Cobb angle was 42.90 ± 7.96° before operation, 14.68 ± 2.44° after operation, and 17.50 ± 2.64° at the latest follow-up, giving a correction of 65.7 %. The correction rate of segmental kyphotic curve was 72.6 %, as the mean segmental kyphotic angle was 22.64 ± 6.74° before operation, 6.15 ± 2.50° after operation, and 6.9° at the latest follow-up, with a loss of 6.90 ± 2.68°.
Conclusions
For the patients whose congenital kyphoscoliosis are due to hemivertebrae, selective partial hemivertebra excision and instrumentation via posterior-only approach is recommended to those ranging from 9 to 14 years old, with the Risser sign range grades 0–3 and Cobb angles <60°. This individualized treatment can balance the growth on the two sides of the spine and achieve satisfactory therapeutic effect through removing excrescent growth center.