One-stage hemivertebra excision in treating congenital spinal deformities caused chiefly by hemivertebra through a single posterior procedure

Objective To evaluate the effect and feasibility of one-stage hemivertebra excision and internal fixation in treating congenital spinal deformities caused chiefly by hemivertebra through a single posterior procedure. Methods 11 cases with congenital spinal deformities caused chiefly by hemivertebra were treated by one-stage hemivertebra excision and internal fixation through a single posterior procedure between October 1998 and June 2003. There were 5 boys and 6 girls with an average age of 15.4 years (range, 2.5 to 23 years). The location of hemivertebra was at thoracic region in 4 cases, thoracolumbar region in 4 cases, and lumbar region in 3 cases. Of these cases, there were 7 cases with a fully segmented hemivertebrae, 2 cases with multiple hemivertebra, and 2 cases associated with contralateral bar or rib fusion. The average Cobb's angle of scoliosis was 60.5° preoperatively, and 3 cases were associated with kyphosis with the Cobb's angle 13°, 27° and 48° respectively. The average trunk shift was 21.2 mm(range, 4 to 36.7 mm). Internal fixations, which were used for the correction of the deformities, included TSRH in 6 cases, CD in 2 cases, China Great wall in 2 cases, and SYNERGY in 1 case. Results The follow-up ranged from 8 months to 4 years and 8 months with an average of 1 years and 10 months. The average fused vertebra was 8.4 segments (range, 2 to 11 segments). The postoperative average Cobb's angle of scoliosis was 18.7°(range, 0° to 24°), and the Cobb's angle of kyphosis was -11°, -8° and 0° respectively. The mean improvement rate was 69.1%. The average trunk shift was improved to 6.2 mm (range, 0 to 16.3 mm). There was no significant correction loss of the scoliosis, kyphosis and the trunk shift at final follow-up evaluation. The intraoperative complications included laminar and pedicle fractures in 2 cases, 1 case had exudates of incision and instability after surgery. There was no other complication happened during follow-up. Conclusion The effect of one-stage posterior hemivertebra excision and internal fixation through a single posterior procedure was satisfactory and reliable in the treatment of congenital spinal deformities caused chiefly by hemivertebra.