Short fixation with a 3‐rod technique for posterior hemivertebra resection in children younger than 5 years old

Abstract

ABSTRACT Importance Congenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation. However, implant‐related complications are common in children younger than 5 years old who undergo this surgical procedure. Objective To present the preliminary clinical and radiological outcomes of children younger than 5 years old treated by posterior hemivertebra resection and 3‐rod fixation technique. Methods From January 2016 to December 2017, 14 consecutive patients of congenital scoliosis with 16 hemivertebrae were retrospectively reviewed, including 5 girls and 9 boys, aged between 25 and 55 months old (average, 37.6 months). All patients underwent posterior hemivertebra resection with short fixation with bilateral pedicle screws and a convex lamina hook. Surgical complications and corrective outcomes were assessed based on the clinical charts and spinal radiographs with a minimum 24‐month follow‐up. Results The mean Cobb angle of the main curve was 38.4° before surgery, 8.5° after surgery, and 8.7° at final follow‐up. In the compensatory cranial curve, the preoperative Cobb angle of 16.8° was corrected to 8.1° postoperatively and was 10.3° at final follow‐up. In the compensatory caudal curve, the preoperative Cobb angle of 15.9° improved to 5.3° postoperatively and was 7.8° at final follow‐up. The segmental kyphosis was corrected from 13.5° to 0.5° and was 1.1° at final follow‐up. There were no crankshaft phenomena, no proximal kyphosis, and no complications related to the instrumentation. Interpretation Posterior hemivertebra resection with instrumentation with bilateral pedicle screws and a convex lamina hook can achieve rigid fixation and deformity correction.

Keywords

• Congenital scoliosis
• Hemivertebra
• Lamina hook
• Pedicle screw