E-ISSN: 2147-5903
RESULTS OF COMPLETE HEMIVERTEBRA EXCISION WITH A POSTERIOR APPROACH ALONE, FOLLOWED BY CIRCUMFERENTIAL FUSION AND POSTERIOR INSTRUMENTATION, IN PATIENTS WITH FULLY SEGMENTED AND UNINCARCERATED HEMIVERTEBRAE
PDF
Cite
Share
Request
Original Article
VOLUME: 25 ISSUE: 2
P: 87-96
April 2014

RESULTS OF COMPLETE HEMIVERTEBRA EXCISION WITH A POSTERIOR APPROACH ALONE, FOLLOWED BY CIRCUMFERENTIAL FUSION AND POSTERIOR INSTRUMENTATION, IN PATIENTS WITH FULLY SEGMENTED AND UNINCARCERATED HEMIVERTEBRAE

J Turk Spinal Surg 2014;25(2):87-96
Doğaç KARAGÜVEN 1
İ. Teoman BENLİ 2
Mehmet AYDOĞAN 3
1. Orthopedics and Traumatology Specialist, Ufuk University Medical School, Orthopedics and Traumatology Department, Ankara.
2. Prof. Dr., Orthopedics and Traumatology Specialist, Hisar Intercontinental Hospital, Orthopedics and Traumatology Specialist Department Chief, İstanbul.
3. Assoc. Dr., Orthopedics and Traumatology Specialist, Bosphorus Spinal Surgery Center, İstanbul.
No information available.
No information available
Received Date: 01.12.2013
Accepted Date: 01.03.2014
PDF
Cite
Share
Request

ABSTRACT

Objective:

To evaluate the results of surgical treatment of patients with an unincarcerated fully-segmented hemivertebra treated with hemivertebrectomy by a posterior approach alone, circumferential fusion and posterior segmental pedicular screw instrumentation.

Study Design:

Twelve patients with a mean age of 9.4 ± 5.4 (2–14) years were included in the study (6 girls and 6 boys). The mean duration of follow-up was 59.4 ± 39.6 (24–132) months. Diagnosis of a Type-IA hemivertebra was established by clinical, radiological, CT and MRI evaluation. For all patients, hemivertebrectomy with a posterior approach alone, circumferential fusion and posterior segmental pedicular screw instrumentation were applied. Analysis of the frontal and sagittal planes using radiograms obtained preoperatively, postoperatively, and after a minimum period of two years was performed. The balance was analyzed clinically and radiologically by measurement of the lateral trunk shift (LT).

Results:

The mean preoperative Cobb angle was 5.5 ± 23.4°, and postoperatively a mean correction rate of 89.4 ± 14.4% was obtained for the main curves (p=0.00). The mean preoperative Cobb angle of the secondary curves was 38.9 ± 16.1°, and postoperatively a mean correction rate of 88.9 ± 11.1% was obtained for the secondary curves (p=0.00). In the final follow-up, the mean loss of correction was 3.2 ± 3.3°. The local segmented kyphosis decreased from 24.4 ± 14.9° to 7.7 ± 5.7°. The trunk shift (LT) of the patients was corrected for all patients (preoperative mean LT: 3.3 ± 2.1 cm; postoperative mean LT: 0.7 ± 0.4 cm). Circumferential fusion was achieved in all cases. No neurological complications developed, the only complication seen was delayed wound healing.

Conclusion:

In the light of these data, we conclude that hemivertebrectomy by a posterior approach alone, circumferential fusion and posterior segmental pedicular screw instrumentation is an effective and safe technique for the treatment of unincarcerated fully-segmented hemivertebrae in all vertebral regions.

Keywords:
Congenital scoliosis, surgical treatment, and hemivertebra excision.