title: Three rod technique facilitates hemivertebra wedge excision in young children through a posterior only approach.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To study the efficacy of a 3-rod technique used in hemivertebra excision via a posterior only approach in young children to avoid implant failure.
  
  
  BACKGROUND
  Previous reports of posterior only hemivertebra excisions in young children have been associated with an unacceptable amount of implant failures and high revision rates.
  
  
  METHODS
  We reviewed our clinical experience in young children who underwent excision of a hemivertebra from a posterior only approach. All children had the wedge resection closed using a rod attached to laminar hooks and had the excision site stabilized with an additional 2 rods attached to pedicle screws.
  
  
  RESULTS
  In our series of 10 patients at an average age of 4 years and 3 months, all patients obtained fusion and there were no implant related complications or revisions needed. The average preoperative Cobb measurement of 44 degrees was improved to 8 degrees at most recent follow-up.
  
  
  CONCLUSIONS
  The use of a 3-rod technique during hemivertebra excision in young children helped to avoid any implant failures in our series. We conclude that this technique should be used in young children whose pedicles may not be able to withstand the compressive forces needed to close down the wedge resection site.
authors.affiliation: Department of Orthopedic Surgery, Children's Hospital, Harvard Medical School, Boston, MA, USA. daniel.hedequist@childrens.harvard.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Hedequist
authors.forename: John
authors.initials: J
authors.lastname: Emans
authors.forename: Mark
authors.initials: M
authors.lastname: Proctor
mesh_terms: D001858:Bone Nails; D001863:Bone Screws; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013121:Spinal Curvatures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*