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Article: The efficacy and complications of posterior hemivertebra resection
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TitleThe efficacy and complications of posterior hemivertebra resection
 
AuthorsZhang, J2
Shengru, W2
Qiu, G2
Yu, B2
Yipeng, W2
Luk, KDK1
 
Issue Date2011
 
PublisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586
 
CitationEuropean Spine Journal, 2011, v. 20 n. 10, p. 1692-1702 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00586-011-1710-0
 
AbstractThere have been several reports on hemivertebra resection via a posterior-only procedure. However, the number of reported cases is small, and various types of instrumentation have been used. In our study, we retrospectively investigated 56 consecutive cases of congenital scoliosis that were treated by posterior hemivertebra resection with transpedicular instrumentation. Radiographs were reviewed to determine the type and location of the hemivertebra, the coronal curve magnitude and the sagittal alignment pre-operatively, post-operatively and at the latest follow-up. Radiographs were also used to assess implant failure and inter-body fusion. Surgical reports and patient charts were reviewed to record any peri-operative complications. Fifty-eight posterior hemivertebrae resections from 56 patients aged 1.5-17 years with fully segmented non-incarcerated hemivertebra were evaluated. The average age at surgery was 9.9 years (1.5-17 years). The average follow-up was 32.9 months (24-58 months). The mean fusion level was 5.0 segments (2-11 segments). There was a mean improvement of 72.9% in the segmental scoliosis, from 42.4° before surgery to 12.3° at the time of the latest follow-up, and there was a mean improvement of 70% in segmental kyphosis from 42.0° to 14.5° over the same time period. The thoracic kyphosis (T5-T12) averaged 10.8° before surgery and 23.9° at the latest follow-up. The lumbar lordosis (L1-S1) averaged -52.8° before surgery and -51.6° at the latest follow-up. Two cases with neurological claudications had complete recovery immediately after the surgery. There was one case of delayed wound healing, two fractures of the pedicle at the instrumented level, two rod breakages and one proximal junction kyphosis that required revision. There were no neurological complications. Radiolucent gaps were found in the residual space after resection on the lateral view in five cases, without any sign of implant failure or correction loss. Our results show that one-stage posterior hemivertebra resection with transpedicular instrumentation can achieve excellent correction, 360° decompression and short fusion without neurological complications. Pedicle cutting still remains a challenge in younger children when using bisegmental instrumentation. In addition, the radiolucent gaps in the residual space require further investigation. © The Author(s) 2011.
 
ISSN0940-6719
2013 Impact Factor: 2.473
 
DOIhttp://dx.doi.org/10.1007/s00586-011-1710-0
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorZhang, J
 
dc.contributor.authorShengru, W
 
dc.contributor.authorQiu, G
 
dc.contributor.authorYu, B
 
dc.contributor.authorYipeng, W
 
dc.contributor.authorLuk, KDK
 
dc.date.accessioned2012-10-30T06:05:59Z
 
dc.date.available2012-10-30T06:05:59Z
 
dc.date.issued2011
 
dc.description.abstractThere have been several reports on hemivertebra resection via a posterior-only procedure. However, the number of reported cases is small, and various types of instrumentation have been used. In our study, we retrospectively investigated 56 consecutive cases of congenital scoliosis that were treated by posterior hemivertebra resection with transpedicular instrumentation. Radiographs were reviewed to determine the type and location of the hemivertebra, the coronal curve magnitude and the sagittal alignment pre-operatively, post-operatively and at the latest follow-up. Radiographs were also used to assess implant failure and inter-body fusion. Surgical reports and patient charts were reviewed to record any peri-operative complications. Fifty-eight posterior hemivertebrae resections from 56 patients aged 1.5-17 years with fully segmented non-incarcerated hemivertebra were evaluated. The average age at surgery was 9.9 years (1.5-17 years). The average follow-up was 32.9 months (24-58 months). The mean fusion level was 5.0 segments (2-11 segments). There was a mean improvement of 72.9% in the segmental scoliosis, from 42.4° before surgery to 12.3° at the time of the latest follow-up, and there was a mean improvement of 70% in segmental kyphosis from 42.0° to 14.5° over the same time period. The thoracic kyphosis (T5-T12) averaged 10.8° before surgery and 23.9° at the latest follow-up. The lumbar lordosis (L1-S1) averaged -52.8° before surgery and -51.6° at the latest follow-up. Two cases with neurological claudications had complete recovery immediately after the surgery. There was one case of delayed wound healing, two fractures of the pedicle at the instrumented level, two rod breakages and one proximal junction kyphosis that required revision. There were no neurological complications. Radiolucent gaps were found in the residual space after resection on the lateral view in five cases, without any sign of implant failure or correction loss. Our results show that one-stage posterior hemivertebra resection with transpedicular instrumentation can achieve excellent correction, 360° decompression and short fusion without neurological complications. Pedicle cutting still remains a challenge in younger children when using bisegmental instrumentation. In addition, the radiolucent gaps in the residual space require further investigation. © The Author(s) 2011.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationEuropean Spine Journal, 2011, v. 20 n. 10, p. 1692-1702 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00586-011-1710-0
 
dc.identifier.citeulike8919814
 
dc.identifier.doihttp://dx.doi.org/10.1007/s00586-011-1710-0
 
dc.identifier.epage1702
 
dc.identifier.hkuros207331
 
dc.identifier.issn0940-6719
2013 Impact Factor: 2.473
 
dc.identifier.issue10
 
dc.identifier.pmid21318279
 
dc.identifier.scopuseid_2-s2.0-84855204962
 
dc.identifier.spage1692
 
dc.identifier.urihttp://hdl.handle.net/10722/170190
 
dc.identifier.volume20
 
dc.languageeng
 
dc.publisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586
 
dc.publisher.placeGermany
 
dc.relation.ispartofEuropean Spine Journal
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshChild
 
dc.subject.meshChild, Preschool
 
dc.subject.meshFemale
 
dc.subject.meshFollow-Up Studies
 
dc.subject.meshHumans
 
dc.subject.meshInfant
 
dc.subject.meshMale
 
dc.subject.meshPostoperative Complications - Diagnosis - Etiology
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshScoliosis - Congenital - Surgery
 
dc.subject.meshSpinal Fusion - Adverse Effects - Methods
 
dc.subject.meshTreatment Outcome
 
dc.titleThe efficacy and complications of posterior hemivertebra resection
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Peking Union Medical College