Efficacy of hemivertebra resection for congenital scoliosis: A multicenter retrospective comparison of three surgical techniques

Burt Yaszay, Michael OBrien, Harry L. Shufflebarger, Randal R. Betz, Baron Lonner, Suken A. Shah, Oheneba Boachie-Adjei, Alvin Crawford, Lynn Letko, Jurgen Harms, Munish C. Gupta, Paul D. Sponseller, Mark F. Abel, John Flynn, Angel MacAgno, Peter O. Newton

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Study Design: Multicenter, retrospective study. Objective: To compare the outcomes of three surgical treatments for congenital spinal deformity due to a hemivertebra. Summary of Background Data: Congenital anomalies of the spine can cause significant and progressive scoliosis and kyphosis. Their management may be challenging and controversy remains over the "best" surgical treatment. Methods: A multicenter retrospective study of patients with congenital spinal deformity due to 1 or 2 level hemivertebra(e) was performed. The surgical treatments included hemiepiphysiodesis or in situ fusion (group 1), instrumented fusion without hemivertebra excision (group 2), or instrumented hemivertebra excision (group 3). Results: Seventy-six patients with minimum 2-year follow-up were evaluated. The mean age was 8 years (range: 1-18). The hemivertebra were fully segmented, nonincarcerated (67%), incarcerated (1%), and semisegmented (32%). There were 65 patients with single hemivertebra and 11 patients with double hemivertebra. There were 14 (18.4%) group 1, 20 (26.3%) group 2, and 42 (55.3%) group 3 patients. Group 1 (37 ± 14°) and group 3 (35 ± 26°) patients had smaller preoperative curves than group 2 patients (55 ± 26°) (P < 0.01). Group 3 had better percent correction at 2 years than groups 1 and 2 (P < 0.001). Group 3 had shorter fusion (P = 0.001), less estimated blood loss (EBL, P = 0.03), and a trend toward shorter operative times than group 2 (P = 0.10). The overall complication rate for the entire group was 30% group 1 (23%), group 2 (17%), and group 3 (44%) (P = 0.09). Conclusion: While hemivertebra resection for congenital scoliosis had a higher complication rate than either hemiepiphysiodesis/in situ fusion or instrumentated fusion without resection, posterior hemivertebra resection in younger patients resulted in better percent correction than the other two techniques.

Original languageEnglish (US)
Pages (from-to)2052-2060
Number of pages9
JournalSpine
Volume36
Issue number24
DOIs
StatePublished - Nov 15 2011

Keywords

  • congenital scoliosis
  • hemivertebra resection
  • spinal instrumentation
  • treatment outcomes

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

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