Abstract:

Objective To evaluate the early clinical outcome of one-stage posterior hemivertebral resection and segmental multi-rod instrumentation for the treatment of medium-to-severe rigidity congenital kyphoscoliosis caused by a single hemivertebrae. Methods Seventeen patients with medium-to-severe rigidity congenital kyphoscoliosis were surgically treated by the posterior hemivertebral resection and segmental multi-rod instrumentation. Hemivertebrae were sited in T10(2 cases), T11(4 cases), T12(5 cases), L1(3 cases), and L2(3 cases). The preoperative scoliotic Cobb angles were (67.9±8.2)° and kyphotic Cobb angles were (73.0±10.6)°. Results All patients underwent surgeries safely and there were no death or neurological injuries occurred. The operation time was 4.0-7.5 h (averaged 5.6 h) and the perioperative bleeding was 500-3 000 mL (averaged 1 050 mL). One patient suffered from left pleura tearing during capitulum costae resection and incurred hemopneumothorax. The patient was treated by chest cavity closed drainage and recovered completely after one week. All cases were followed up for 12-35 months (averaged 19.4 months). Bony fusion was achieved in all patients and no pseudoarthrosis and implant failure was observed. The Cobb angles of scoliosis and kyphosis after one week of operations and at the time of the last follow-up were much better than those before the operations. The differences were statistically significant (P<0.05). Conclusion The one-stage posterior hemivertebral resection and segmental multi-rod instrumentation is feasible and effective in correcting scoliosis and kyphosis for the treatment of medium-to-severe rigidity congenital kyphoscoliosis caused by a single hemivertebrae.

Key words: congenital kyphoscoliosis, posterior hemivertebra resection, rigid