Skip to main content

Selective hemivertebrae resection in a congenital scoliosis patient with multiple hemivertebrae deformities

Abstract

Purpose

To report the surgical experience of selective hemivertebrae resection for a case of congenital scoliosis with multiple hemivertebrae deformities.

Methods

A 14-year-old male presented with progressive rib hump, tilted torso and spine deformity was admitted in our department. No abnormalities were detected in neurological examination and the comprehensive imaging study demonstrated congenital scoliosis of multiple hemivertebrae in T5, T10, L1 and L3. Treatment of the patient commenced with a 10-day skin traction therapy prior to the surgery. Selective resection of hemivertebrae in T5 and L1 was performed with segmental fusion from T3 to L2.

Results

After surgical procedure, the patient achieved a good coronal and sagittal balance along with a good correction of the curve. 18-month postoperative follow-up showed no evidence of significant loss of correction. No device-related complication such as implant loosening or failure or neurologic complication occurred during the follow-up. Besides, patient’s shoulder balance was further improved and coronal balance was maintained in a normal range.

Conclusion

Many factors have to be considered in the clinical decision-making of congenital scoliosis with multiple hemivertebrae deformities patients. Much emphasis in this regard is laid on the type and location of the hemivertebrae as well as the patient’s age. Selective hemivertebrae resection may be more suitable for such patients.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Winter RB, Moe JH, Wang JF (1973) Congenital kyphosis. Its natural history and treatment as observed in a study of one hundred and thirty patients. J Bone Jt Surg Am 55:223–256

    CAS  Article  Google Scholar 

  2. McMaster MJ, Ohtsuka K (1982) The natural history of congenital scoliosis. A study of two hundred and fifty-one patients. J Bone Jt Surg Am 64:1128–1147

    CAS  Article  Google Scholar 

  3. Chang DG, Yang JH, Lee JH, Kim JH, Suh SW, Ha KY, Suk SI (2016) Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up. J Neurosurg Spine 25:225–233. doi:10.3171/2015.11.SPINE151099

    Article  PubMed  Google Scholar 

  4. Chang DG, Kim JH, Ha KY, Lee JS, Jang JS, Suk SI (2015) Posterior hemivertebra resection and short segment fusion with pedicle screw fixation for congenital scoliosis in children younger than 10 years: greater than 7-year follow-up. Spine (Phila Pa 1976) 40:E484–E491. doi:10.1097/BRS.0000000000000809

    Article  Google Scholar 

  5. Mladenov K, Kunkel P, Stuecker R (2012) Hemivertebra resection in children, results after single posterior approach and after combined anterior and posterior approach: a comparative study. Eur Spine J 21:506–513. doi:10.1007/s00586-011-2010-4

    Article  PubMed  Google Scholar 

  6. Guo J, Zhang J, Wang S, Zhang Y, Yang Y, Yang X, Zhao L (2016) Surgical outcomes and complications of posterior hemivertebra resection in children younger than 5 years old. J Orthop Surg Res 11:48. doi:10.1186/s13018-016-0381-2

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ruf M, Jensen R, Letko L, Harms J (2009) Hemivertebra resection and osteotomies in congenital spine deformity. Spine (Phila Pa 1976) 34:1791–1799. doi:10.1097/BRS.0b013e3181ab6290

    Article  Google Scholar 

  8. McMaster MJ, David CV (1986) Hemivertebra as a cause of scoliosis. A study of 104 patients. J Bone Jt Surg Br 68:588–595

    CAS  Google Scholar 

  9. Zhuang Q, Zhang J, Li S, Wang S, Guo J, Qiu G (2016) One-stage posterior-only lumbosacral hemivertebra resection with short segmental fusion: a more than 2-year follow-up. Eur Spine J 25:1567–1574. doi:10.1007/s00586-015-3995-x

    Article  PubMed  Google Scholar 

  10. Ruf M, Harms J (2003) Posterior hemivertebra resection with transpedicular instrumentation: early correction in children aged 1 to 6 years. Spine (Phila Pa 1976) 28:2132–2138. doi:10.1097/01.BRS.0000084627.57308.4A

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yong Hai.

Ethics declarations

Conflict of interest

None of the authors has any potential conflict of interest. No funds were received in support of this work. No relevant financial activities outside the submitted work.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zhang, Y., Yang, J., Zhou, L. et al. Selective hemivertebrae resection in a congenital scoliosis patient with multiple hemivertebrae deformities. Eur Spine J 26, 1577–1583 (2017). https://doi.org/10.1007/s00586-017-4960-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-017-4960-7

Keywords

  • Congenital scoliosis
  • Hemivertebrae
  • Pedicle screw fixation
  • Spinal fusion
  • Hemivertebrae resection