Resección hemivertebral toracolumbar por doble enfoque en un solo procedimiento.

Bollini, Gerard MD, PhD *; Docquier, Pierre-Louis MD +; Viehweger, Elke MD *; Launay, Franck MD *; Jouve, Jean-Luc MD, PhD *

Abstract:

Study Design. Retrospective review of patients records with clinical and radiographic assessment.

Objective. To evaluate the long-term result of thoracolumbar hemivertebrae resection using a double approach in a single procedure.

Summary of Background Data. Thoracolumbar hemivertebrae resection by a combined posterior and anterior approach has been previously described, but this is the largest series of hemivertebrae reported.

Methods. From 1987 to 2003, a consecutive series of 34 congenital scoliosis or kyphoscoliosis due to thoracolumbar hemivertebrae were managed by hemivertebra resection using a combined posterior and anterior approach and short anterior and posterior convex fusion in the same day/same anesthesia.

Results. The mean age at surgery was 3.5 years. The mean follow-up period was 6.0 years. There was a mean improvement of 69.3% in the segmental curve from a mean angle of 34.8[degrees] before surgery to 10.7[degrees] at the latest follow-up assessment. The global scoliosis curve improved of 33.4% from 40.4[degrees] to 26.9[degrees], respectively. Trunk shift was significantly improved. The mean final kyphosis was within normal values.

Conclusions. This procedure is safe and offers a persistent correction with a short segment fusion. Surgery should be performed as early as possible to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.