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Hemivertebrectomy in Early Onset Scoliosis

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The Growing Spine

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Abstract

Hemivertebra (HV) occur due to a failure of formation. Hemivertebrectomy may be indicated for progressive early onset scoliosis (EOS) with an isolated HV. Additional indications for surgery include trunk imbalance and impending or actual spinal cord insult (usually from congenital kyphosis due to HV). Initial management with nonoperative techniques such as bracing or casting may offer value in delaying the timing of surgery to allow the child to grow. Posterior hemivertebrectomy is the recommended surgical technique by the Scoliosis Research Society (SRS). Pedicle screw instrumentation offers the greatest stability to hold the achieved correction but can be challenging in young children. Image guidance or navigation is advised for pedicle screw placement. Utilizing a central rod on sublaminar hooks for correction can reduce stress placed on the pedicle screws during corrective maneuvers. Complications during and after surgery occur in up to 30% of patients. Fortunately, permanent neurologic injury is rare. Long-term results of hemivertebrectomy are generally satisfactory; however, there are no high-quality studies reporting functional or health-related quality of life.

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Authors and Affiliations

  1. Department of Orthopedics, University of Colorado, Children’s Hospital Colorado, Aurora, CO, USA

    Sumeet Garg

  2. Pediatric Orthopedic Department, Service Pr. JL. Jouve, Timone Children’s Hospital, Marseilles, France

    Gerard Bollini

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  1. Sumeet Garg
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  2. Gerard Bollini
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Correspondence to Sumeet Garg .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, USA

    Behrooz A. Akbarnia

  2. Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    George H. Thompson

  3. Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey

    Muharrem Yazici

  4. IWK Health Center, Dalhousie University, Halifax, NS, Canada

    Ron El-Hawary

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Garg, S., Bollini, G. (2022). Hemivertebrectomy in Early Onset Scoliosis. In: Akbarnia, B.A., Thompson, G.H., Yazici, M., El-Hawary, R. (eds) The Growing Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-84393-9_31

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  • DOI: https://doi.org/10.1007/978-3-030-84393-9_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84392-2

  • Online ISBN: 978-3-030-84393-9

  • eBook Packages: MedicineMedicine (R0)

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