HEMIVERTEBRAL RESECTION – SURGICAL TECHNIQUE

Abstract

Introduction. Hemivertebra is a malformation due to failure of formation, with significant repercussions on the normal growth and development of the spine, whose conservative treatment cannot prevent the progression of the scoliotic curve. Material and method. We present the surgical technique described by Ruff and Harms for the resection of hemivertebra by posterior only approach and limited fusion, applied by us in 12 hemivertebra (9 patients). Results. The postoperatory correction was 70,56%, which remained unchanged at the 1 year follow-up, similar to the correction described in the literature regarding this technique. Discussions. Comparing this technique with the other treatments described in the literature, like in situ fusion, convex hemiepiphisiodesis, hemivertebra excision via simultaneous anterior and posterior exposures, we may observe that the hemivertebra resection using a posterior only approach, followed by segmental spinal fusion, is superior in terms of results, evolution and complications. Conclusions. This technique represents the “golden standard” for the early correction of the scoliotic curve, before the occurrence of secondary structural changes, allowing a good corection, limited fusion and a cvasinormal spinal growth.

Keywords

• hemivertebra resection
• posterior approach
• segmental spinal fusion