Huang Qi,Xu Jianglong,Su Yuxi,et al.Efficacy of one-stage posterior hemivertebrectomy and short segment fusion for congenital hemivertebra malformations:a multicenter clinical study[J].Journal of Clinical Pediatric Surgery,,():521-526.[doi:10.3760/cma.j.cn101785-202405076-004]
Efficacy of one-stage posterior hemivertebrectomy and short segment fusion for congenital hemivertebra malformations:a multicenter clinical study
- Keywords:
- Scoliosis; Congenital; Laminectomy; Spinal Fusion; Treatment Outcome; Multicenter Studies as Topic
- Abstract:
- Objective To evaluate the efficacy of one-stage posterior hemivertebrectomy and short segment fusion for congenital hemivertebra deformity in children at multiple medical centers.Methods This retrospective study included 35 children with single-level thoracic or lumbar hemivertebra who undergoing one-stage posterior hemivertebrectomy and short segment fusion at six medical centers between May 2016 and March 2021.The follow-up period was at least 2 years.General profiles,measurements of coronal main curve Cobb angle,proximal compensatory curve,distal compensatory curve,coronal balance,sagittal segmental kyphosis angle and complications were recorded at preoperation,postoperation and final follow-up visits for evaluating surgical outcomes.Results There were 18 boys and 17 girls with hemivertebra in T2-10 (n=10),T11-L2 (n=17) and L3-5 (n=8).Average number of fused segments was 2.4.Operative age was (4.5±2.6) year and follow-up period (42.6±17.6) month.Preoperative coronal main curve Cobb angle was (37.6°±9.0°),postoperative angle (9.0°±6.4°) and final follow-up angle (13.3°±11.1°).Correction rates at postoperation and final follow-up were 76.1% and 64.6%.Correction rates of proximal compensatory curve and distal compensatory curve were 44.4% and 57.1%.Correction rate of segmental kyphosis was 37.2%.Significant differences existed in postoperation and final follow-up coronal main curve Cobb angles,proximal compensatory curve,distal compensatory curve and sagittal segmental kyphosis angle as compared with preoperative values (P<0.05).Complications included pedicle cutting (11.4%,4/35),deformity progression (8.6%,3/35) and infection (2.9%,1/35).No neurological complication was reported.Conclusions One-stage posterior hemivertebrectomy and short segment fusion are both safe and effective for treating single-level thoracic or lumbar hemivertebra deformities in children.This surgical approach directly addresses the underlying cause of deformity and preserves spinal growth and function.Nevertheless,meticulous cares and proactive preventions of postoperative complications,such as pedicle cutting and deformity progression,are necessary.
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Memo
收稿日期:2024-05-29。
基金项目:广东省高水平医院建设专项经费(粤府办[2021]6号);深圳市"医疗卫生三名工程"项目资助(SZSM202011012)
通信作者:徐江龙,Email:xjl0604@126.com