New technique in congenital scoliosis involving fixation to the pelvis after hemivertebra excision.
METHODS
The authors conducted a retrospective study involving description of a new surgical technique.


OBJECTIVE
The objective of this study was to describe and evaluate the efficacy of a new technique to stabilize the spine of young and small patients with congenital scoliosis after lumbosacral hemivertebra excision.


BACKGROUND
Congenital scoliosis develops as the result of anomalous vertebral development and asymmetric growth. The vertebral anomalies include congenital fusions and congenital hemivertebrae. With lumbosacral hemivertebrae at the lumbosacral junction, surgical excision followed by instrumentation to close the resulting space is frequently the best way to correct the deformity and obtain spinal balance. Surgical stabilization is required for preventing recurrent deformity and restoration of spinal balance.


METHODS
A new surgical technique for spinal correction and stabilization in congenital scoliosis is described. The technique involves hemivertebra excision followed by fixation of the adjacent normal vertebra to the ilium with screws and cables. This technique allows efficient correction in both the coronal and sagittal planes.


RESULTS
This construct was prospectively studied in 3 cases over a 3- to 5(1/2)-year period. All cases had solid fusion and well-balanced spine at latest follow up.


CONCLUSIONS
This prospective study demonstrates a successful surgical technique for spinal stabilization after congenital hemivertebra excision in infants and young children with relatively small and soft bones when standard constructs like pedicle screws may not be optimal devices. Coronal and sagittal balance (restoration with improvement of lordosis) was successfully achieved in all cases.
Hosalkar
Harish S
HS
Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Luedtke
Lael M
LM
Drummond
Denis S
DS
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*