title: Posterior hemivertebra resection and short segment fusion with pedicle screw fixation for congenital scoliosis in children younger than 10 years: greater than 7-year follow-up.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  To evaluate the surgical outcomes of posterior hemivertebra resection and short segment fusion with segmental pedicle screw fixation in congenital scoliosis in children younger than 10 years.
  
  
  BACKGROUND
  This is the first long-term follow-up on surgical outcomes of posterior hemivertebra resection and short segment fusion using segmental pedicle screw fixation in children younger than 10 years with congenital scoliosis.
  
  
  METHODS
  Patients with congenital scoliosis (n = 18) younger than 10 years at the time of the surgery were treated by posterior hemivertebra resection and bilateral pedicle screw fixation. The mean age at the time of surgery was 6.6 years (range, 2.6-9.8 yr). They were retrospectively studied with a mean follow-up of 11.4 years (range, 7.1-17.3 yr).
  
  
  RESULTS
  The mean Cobb angle of the main curve was 34.4° before surgery, 8.6° after surgery, and 12.9° at last follow-up. In the compensatory cranial curve, the preoperative Cobb angle of 14.5° was corrected to 5.9° postoperatively and was 8.4° at last follow-up. In the compensatory caudal curve, the preoperative Cobb angle of 17.4° improved to 4° postoperatively and 6.6° at last follow-up. There were no crankshaft phenomena and no clinical and radiographical features suggestive of spinal stenosis during follow-up. There were no major vascular or neurological complications related to the pedicle screws.
  
  
  CONCLUSIONS
  Posterior hemivertebra resection after pedicle screw fixation in congenital scoliosis is a safe and effective procedure that can achieve rigid fixation and deformity correction and restore spinal balance. This study showed that early posterior hemivertebra resection of congenital scoliosis before structural changes occur above or below can reduce fusion length, prevent curve progression, and effectively achieve a more satisfactory correction without hazardous iatrogenic spinal stenosis, crankshaft phenomena, or neurological complications.
  
  
  METHODS
  3.
authors.affiliation: *Seoul Spine Institute, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea †Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; and ‡Department of Orthopaedic Surgery, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Dong-Gune
authors.initials: DG
authors.lastname: Chang
authors.forename: Jin-Hyok
authors.initials: JH
authors.lastname: Kim
authors.forename: Kee-Yong
authors.initials: KY
authors.lastname: Ha
authors.forename: Jung-Sub
authors.initials: JS
authors.lastname: Lee
authors.forename: Ji-Seok
authors.initials: JS
authors.lastname: Jang
authors.forename: Se-Il
authors.initials: SI
authors.lastname: Suk
mesh_terms: D001863:Bone Screws; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery; D008141:Lordosis / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D013115:Spinal Canal / Q000000981:diagnostic imaging; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome