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Article: Ten-year follow-up study of lower thoracic hemivertebrae treated by convex fusion and concave distraction

TitleTen-year follow-up study of lower thoracic hemivertebrae treated by convex fusion and concave distraction
Authors
KeywordsConcave distraction
Congenital scoliosis
Convex epiphysiodesis
Hemivertebra
Issue Date2002
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2002, v. 27 n. 7, p. 748-753 How to Cite?
AbstractStudy Design. A retrospective review of patient records with recent clinical and radiologic assessment was conducted. Objective. To evaluate the long-term results of fully segmented hemivertebrae treated by convex fusion combined with instrumented concave subcutaneous distraction. Summary of Background Data. Convex fusion has been described for the treatment of hemivertebrae in children, whereas distraction without fusion has been shown to enhance spinal growth. No long-term follow-up studies have combined these two methods. Methods. Between 1986 and 1994, six consecutive patients (5 males and 1 female) with hemivertebrae located at T11 or T12 underwent convex anterior and posterior fusion as well as concave subcutaneous distraction without fusion. Results. The mean age at surgery was 3.4 years. The mean follow-up period was 10.8 years (range, 8-14 years). There was a mean improvement of 41% in the coronal deformity, from a mean angle of 49° before surgery to 29° at the latest follow-up assessment. In four of the cases, this correction was achieved immediately after surgery and did not significantly change despite repeated distraction. The kyphosis improved in three cases, remained unchanged in one case, and deteriorated in two cases. In these two cases, an adjacent wedge vertebra contributed to the kyphotic deformity. Conclusions. Although growth-mediated correction was seen in only two cases, this procedure could be recommended for children with severe deformities and decompensation in the lower thoracic spine. It is safer than hemivertebra excision, with less risk of spinal cord injury. The concave distraction produces immediate improvement in the coronal balance, such that there is no need to wait for uncertain growth-mediated correction in patients who undergo convex fusion only.
Persistent Identifierhttp://hdl.handle.net/10722/79508
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorZhang, JGen_HK
dc.contributor.authorLu, DSen_HK
dc.contributor.authorLuk, KDKen_HK
dc.contributor.authorLeong, JCYen_HK
dc.date.accessioned2010-09-06T07:55:28Z-
dc.date.available2010-09-06T07:55:28Z-
dc.date.issued2002en_HK
dc.identifier.citationSpine, 2002, v. 27 n. 7, p. 748-753en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/79508-
dc.description.abstractStudy Design. A retrospective review of patient records with recent clinical and radiologic assessment was conducted. Objective. To evaluate the long-term results of fully segmented hemivertebrae treated by convex fusion combined with instrumented concave subcutaneous distraction. Summary of Background Data. Convex fusion has been described for the treatment of hemivertebrae in children, whereas distraction without fusion has been shown to enhance spinal growth. No long-term follow-up studies have combined these two methods. Methods. Between 1986 and 1994, six consecutive patients (5 males and 1 female) with hemivertebrae located at T11 or T12 underwent convex anterior and posterior fusion as well as concave subcutaneous distraction without fusion. Results. The mean age at surgery was 3.4 years. The mean follow-up period was 10.8 years (range, 8-14 years). There was a mean improvement of 41% in the coronal deformity, from a mean angle of 49° before surgery to 29° at the latest follow-up assessment. In four of the cases, this correction was achieved immediately after surgery and did not significantly change despite repeated distraction. The kyphosis improved in three cases, remained unchanged in one case, and deteriorated in two cases. In these two cases, an adjacent wedge vertebra contributed to the kyphotic deformity. Conclusions. Although growth-mediated correction was seen in only two cases, this procedure could be recommended for children with severe deformities and decompensation in the lower thoracic spine. It is safer than hemivertebra excision, with less risk of spinal cord injury. The concave distraction produces immediate improvement in the coronal balance, such that there is no need to wait for uncertain growth-mediated correction in patients who undergo convex fusion only.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectConcave distractionen_HK
dc.subjectCongenital scoliosisen_HK
dc.subjectConvex epiphysiodesisen_HK
dc.subjectHemivertebraen_HK
dc.titleTen-year follow-up study of lower thoracic hemivertebrae treated by convex fusion and concave distractionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0887-9869&volume=27&issue=7&spage=748&epage=753&date=2002&atitle=Ten-year+follow+up+study+of+lower+thoracic+hemivertebrae+treated+by+convex+fusion+and+concave+distractionen_HK
dc.identifier.emailCheung, KMC:cheungmc@hku.hken_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/00007632-200204010-00012en_HK
dc.identifier.pmid11923668-
dc.identifier.scopuseid_2-s2.0-0036533896en_HK
dc.identifier.hkuros71319en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036533896&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume27en_HK
dc.identifier.issue7en_HK
dc.identifier.spage748en_HK
dc.identifier.epage753en_HK
dc.identifier.isiWOS:000174793500011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridZhang, JG=8558508400en_HK
dc.identifier.scopusauthoridLu, DS=7403079533en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.scopusauthoridLeong, JCY=35560782200en_HK

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