TY - JOUR
T1 - Efficacy of hemivertebra resection for congenital scoliosis
T2 - A multicenter retrospective comparison of three surgical techniques
AU - Yaszay, Burt
AU - OBrien, Michael
AU - Shufflebarger, Harry L.
AU - Betz, Randal R.
AU - Lonner, Baron
AU - Shah, Suken A.
AU - Boachie-Adjei, Oheneba
AU - Crawford, Alvin
AU - Letko, Lynn
AU - Harms, Jurgen
AU - Gupta, Munish C.
AU - Sponseller, Paul D.
AU - Abel, Mark F.
AU - Flynn, John
AU - MacAgno, Angel
AU - Newton, Peter O.
PY - 2011/11/15
Y1 - 2011/11/15
N2 - Study Design: Multicenter, retrospective study. Objective: To compare the outcomes of three surgical treatments for congenital spinal deformity due to a hemivertebra. Summary of Background Data: Congenital anomalies of the spine can cause significant and progressive scoliosis and kyphosis. Their management may be challenging and controversy remains over the "best" surgical treatment. Methods: A multicenter retrospective study of patients with congenital spinal deformity due to 1 or 2 level hemivertebra(e) was performed. The surgical treatments included hemiepiphysiodesis or in situ fusion (group 1), instrumented fusion without hemivertebra excision (group 2), or instrumented hemivertebra excision (group 3). Results: Seventy-six patients with minimum 2-year follow-up were evaluated. The mean age was 8 years (range: 1-18). The hemivertebra were fully segmented, nonincarcerated (67%), incarcerated (1%), and semisegmented (32%). There were 65 patients with single hemivertebra and 11 patients with double hemivertebra. There were 14 (18.4%) group 1, 20 (26.3%) group 2, and 42 (55.3%) group 3 patients. Group 1 (37 ± 14°) and group 3 (35 ± 26°) patients had smaller preoperative curves than group 2 patients (55 ± 26°) (P < 0.01). Group 3 had better percent correction at 2 years than groups 1 and 2 (P < 0.001). Group 3 had shorter fusion (P = 0.001), less estimated blood loss (EBL, P = 0.03), and a trend toward shorter operative times than group 2 (P = 0.10). The overall complication rate for the entire group was 30% group 1 (23%), group 2 (17%), and group 3 (44%) (P = 0.09). Conclusion: While hemivertebra resection for congenital scoliosis had a higher complication rate than either hemiepiphysiodesis/in situ fusion or instrumentated fusion without resection, posterior hemivertebra resection in younger patients resulted in better percent correction than the other two techniques.
AB - Study Design: Multicenter, retrospective study. Objective: To compare the outcomes of three surgical treatments for congenital spinal deformity due to a hemivertebra. Summary of Background Data: Congenital anomalies of the spine can cause significant and progressive scoliosis and kyphosis. Their management may be challenging and controversy remains over the "best" surgical treatment. Methods: A multicenter retrospective study of patients with congenital spinal deformity due to 1 or 2 level hemivertebra(e) was performed. The surgical treatments included hemiepiphysiodesis or in situ fusion (group 1), instrumented fusion without hemivertebra excision (group 2), or instrumented hemivertebra excision (group 3). Results: Seventy-six patients with minimum 2-year follow-up were evaluated. The mean age was 8 years (range: 1-18). The hemivertebra were fully segmented, nonincarcerated (67%), incarcerated (1%), and semisegmented (32%). There were 65 patients with single hemivertebra and 11 patients with double hemivertebra. There were 14 (18.4%) group 1, 20 (26.3%) group 2, and 42 (55.3%) group 3 patients. Group 1 (37 ± 14°) and group 3 (35 ± 26°) patients had smaller preoperative curves than group 2 patients (55 ± 26°) (P < 0.01). Group 3 had better percent correction at 2 years than groups 1 and 2 (P < 0.001). Group 3 had shorter fusion (P = 0.001), less estimated blood loss (EBL, P = 0.03), and a trend toward shorter operative times than group 2 (P = 0.10). The overall complication rate for the entire group was 30% group 1 (23%), group 2 (17%), and group 3 (44%) (P = 0.09). Conclusion: While hemivertebra resection for congenital scoliosis had a higher complication rate than either hemiepiphysiodesis/in situ fusion or instrumentated fusion without resection, posterior hemivertebra resection in younger patients resulted in better percent correction than the other two techniques.
KW - congenital scoliosis
KW - hemivertebra resection
KW - spinal instrumentation
KW - treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=80455164548&partnerID=8YFLogxK
U2 - 10.1097/BRS.0b013e318233f4bb
DO - 10.1097/BRS.0b013e318233f4bb
M3 - Article
C2 - 22048650
AN - SCOPUS:80455164548
SN - 0362-2436
VL - 36
SP - 2052
EP - 2060
JO - Spine
JF - Spine
IS - 24
ER -