Anterior instrumentation and correction of congenital spinal deformities under age of four without hemivertebrectomy: a new alternative.
METHODS
Retrospective clinical and radiologic evaluation of a single-stage partial corpectomy of the hemivertebra with anterior instrumentation and simultaneous posterior noninstrumented fusion.


OBJECTIVE
To determine the safety and efficacy of a new technique in the management of progressive congenital spinal deformities due to failure of formation in the very young age.


BACKGROUND
Several techniques have been reported for the surgical treatment of young children with congenital spinal deformities. There have been concerns regarding epidural bleeding, neurologic complications, pedicle screws placement, implant failure, and prominence of posterior constructs in this very young age group. A single-stage partial corpectomy of the hemivertebra with anterior instrumentation and simultaneous posterior noninstrumented fusion can offer a new alternative which can avoid these concerns.


METHODS
Twelve patients with progressive congenital spinal deformities due to failure of formation were retrospectively reviewed after adopting the above mentioned technique. All patients included in the study presented with a single hemivertebra. The mean age at time of surgery was 2 years 7 months (range, 1 year and 9 months to 3 years and 10 months). The average follow-up period was 3 years and 1 month (range, 2 years to 4 years and 5 months).


RESULTS
There were no cases of intra or postoperative neurologic or implant related complications. There was 1 superficial infection. All patients showed solid radiologic fusion. The mean scoliosis angle improved from 48.3° (range, 34°-58°) preoperative to 17.2° (range, 11°-25°). The mean angle of kyphosis improved from 23.2° (range, 16°-57°) before surgery to 11.7° (range, 4°-16°).


CONCLUSIONS
A single-stage partial corpectomy of the hemivertebra with anterior instrumentation and simultaneous posterior noninstrumented fusion offers a safe alternative method in treating patients with congenital hemivertebra under the age of 4 years.
Elsebaie
Hazem B
HB
From the *Cairo University Teaching Hospitals, Cairo, Egypt; †Abulreish Student's Insurance Hospital, Cairo, Egypt; ‡Great Ormond Street Hospital, London, United Kingdom; §University of California, San Diego, CA; and ¶San Diego Center for Spinal Disorders, La Jolla, CA.
Kaptan
Wael
W
El Miligui
Yasser
Y
El Masry
Mohamed A
MA
Salaheldine
Motaz
M
Noordeen
Hilali M
HM
Akbarnia
Behrooz A
BA
D001863:Bone Screws; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome