Thoracolumbar hemivertebrae resection by double approach in a single procedure: long-term follow-up.
METHODS
Retrospective review of patients records with clinical and radiographic assessment.


OBJECTIVE
To evaluate the long-term result of thoracolumbar hemivertebrae resection using a double approach in a single procedure.


BACKGROUND
Thoracolumbar hemivertebrae resection by a combined posterior and anterior approach has been previously described, but this is the largest series of hemivertebrae reported.


METHODS
From 1987 to 2003, a consecutive series of 34 congenital scoliosis or kyphoscoliosis due to thoracolumbar hemivertebrae were managed by hemivertebra resection using a combined posterior and anterior approach and short anterior and posterior convex fusion in the same day/same anesthesia.


RESULTS
The mean age at surgery was 3.5 years. The mean follow-up period was 6.0 years. There was a mean improvement of 69.3% in the segmental curve from a mean angle of 34.8 degrees before surgery to 10.7 degrees at the latest follow-up assessment. The global scoliosis curve improved of 33.4% from 40.4 degrees to 26.9 degrees, respectively. Trunk shift was significantly improved. The mean final kyphosis was within normal values.


CONCLUSIONS
This procedure is safe and offers a persistent correction with a short segment fusion. Surgery should be performed as early as possible to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.
Bollini
Gérard
G
Department of Paediatric Orthopaedic Surgery, Hôpital Timone Enfants, University of Marseille, Marseille, France. Gerard.bollini@ap-hm.fr
Docquier
Pierre-Louis
PL
Viehweger
Elke
E
Launay
Franck
F
Jouve
Jean-Luc
JL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007738:Kyphosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome