Posterior Hemivertebra Extended Resection Combined With Concave Anterior Column Reconstruction for Congenital Scoliosis.

Abstract

Background: Posterior hemivertebra resection for hemivertebra deformities has been widely reported. However, achieving adequate correction of deformities through conventional hemivertebra resection remains technically challenging in older children. The authors developed a technique combining posterior hemivertebra extended resection with concave anterior column reconstruction. This study aimed to evaluate the outcomes of the modified posterior hemivertebra resection (MPHR) technique in older children with rigid congenital scoliosis.

Methods: A retrospective analysis was conducted from June 2016 to February 2023 on 15 patients with congenital scoliosis, all of whom were over 10 years old and had less than 30% flexibility. They underwent posterior hemivertebra extended resection combined with concave anterior column reconstruction. The medical records and radiographs were reviewed to evaluate correction results and complications.

Results: There were 7 males and 8 females with a mean age of 12.9±1.5 years. The mean follow-up time was 2.0±0.4 years. The segmental curve was 41±11 degrees preoperatively, 7±4 degrees postoperatively, and 8±4 degrees at the final follow-up, resulting in a correction rate of 80%. The segmental kyphosis improved from 41±26 to 7±7 degrees, resulting in a correction rate of 83%. The correction rate for the compensatory cranial and caudal curve were 59% and 66%, respectively. There was one superficial wound infection postoperatively.

Conclusions: The MPHR provides satisfactory correction of hemivertebra deformity in older children. The MPHR represents an alternative technique for older children with rigid curves.

Level of evidence: Level IV.