[Comparison of two techniques in hemivertebra resection: anterior- posterior approach versus posterior approach].
OBJECTIVE
To Compare the two techniques in the treatment of congenital kypho-scoliosis caused by fully-segmented hemivertebra.


METHODS
44 consecutive cases, 21 males and 23 females. The average age at surgery was 11.4 years ranging from 2 to 17 years, 20 patients underwent one-stage anterior and posterior hemivertebra resection and instrumentation. 24 patients underwent one-stage posterior hemivertebra resection and instrumentation. Long cassette standing radiographs were taken before and after surgery and at the final follow-up. The apical translation, the Cobb's angle in the coronal and sagittal plane were measured and analyzed. The medical records were reviewed and the complications were recorded.


RESULTS
The average follow-up was 39.2 months ranging from 24 to 72 months. The 2 groups did not demonstrate any significant differences in gender, age at surgery, preoperative and postoperative Cobb angle, blood loss, or fusion segments (all P > 0.05). However, the anterior and posterior group demonstrated a less curve flexibility and longer operative time compared with the posterior groups (all P < 0.05).


RESULTS
the anterior and posterior group included pedical cutting in 1 case, lumber curve decompensation in 1 case and crankshaft phenomenon in 2 cases. The posterior group included pedical cutting in 1 case and length of instrumentation in 1 case.


CONCLUSIONS
Two techniques are safe and effective procedure for the congenital kypho-scoliosis. Anterior and posterior hemivertebra resection is indicated to rigid deformity, and anterior epiphysiodesis is needed to avoid crankshaft phenomenon for patients at an earlier skeletal age. Posterior hemivertebra resection can save operation time and is less invasive compared with anterior-posterior approach.
Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Acadamy of Medical Sciences, Beijing 100730, China.
Wu
W
Sun
Jian-guo
JG
Zhang
Gui-xing
GX
Qiu
Sheng-ru
SR
Wang
Yu-juan
YJ
Zhao
Li-juan
LJ
Zhao
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000151:congenital / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008297:Male; D012600:Scoliosis / Q000151:congenital / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome