title: Fusionless posterior hemivertebra resection in a 2-year-old child with 16 years follow-up.
abstract: OBJECTIVE
  We present the case of a 2-year-old patient with congenital scoliosis due to a lumbar hemivertebra. The current gold standard treatment of such an abnormality would be hemivertebra resection and short level posterior spinal fusion. However, due to the young age of the patient, we considered that application of a fusionless solution might offer advantages in terms of retaining normal segmental motion and the potential for growth.
  
  
  METHODS
  The incarcerated hemivertebra was resected and the facet joints of the neighbouring vertebrae were joined to create a new functional motion segment and correct the kyphoscoliotic deformity. Transpedicular screws were inserted on the convex side in L2 and L3 and a tension band was applied.
  
  
  RESULTS
  16 years after the surgery, the patient was completely pain-free, motion of the lumbar spine was preserved and the physiological curvatures were maintained.
  
  
  CONCLUSIONS
  To our knowledge a fusionless surgical solution for the treatment of a hemivertebra has never been described before. Although this is only a single case, the good result with a long follow-up suggests the technique is worthwhile considering when planning the treatment of a lumbar hemivertebra in very young children.
authors.affiliation: Spine Unit, Schulthess Clinic, Zurich, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Jeszenszky
authors.forename: T F
authors.initials: TF
authors.lastname: Fekete
authors.forename: F S
authors.initials: FS
authors.lastname: Kleinstueck
authors.forename: D
authors.initials: D
authors.lastname: Haschtmann
authors.forename: L
authors.initials: L
authors.lastname: Bognár
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000002:abnormalities / Q000601:surgery*