Adjacent intervertebral disc preservation or not during hemivertebra resection in the treatment of congenital scoliosis: a minimum of 5-year follow-up.

Abstract

Objective: To evaluate and compare whether removing the intervertebral disc (IVD) adjacent to the hemivertebra (HV) affects the therapeutic outcome of hemivertebra resection in pediatric patients.

Methods: Pediatric patients who were diagnosed with single fully segmented or semi-segmented hemivertebra from 2011 to 2018 were included. Patients were grouped based on whether removal of IVD(s) adjacent to HV. Radiographic parameters were evaluated. Operative results were evaluated based on the correction rate after surgery and at the last follow-up. Demographic and surgical data together with perioperative complications were also analyzed.

Results: Total 42 patients were included in our study, including 25 patients in the IVD preservation group (group P) and 17 patients in the IVD removal group (group R). Two groups showed similar results in terms of baseline demographics and operational data other than the estimated blood loss (EBL). The IVD preservation group presented with significantly more EBL. Both two groups showed significant postoperative scoliosis correction. However, no significant difference was found between the two groups in terms of coronal balance and radiographic parameters in the sagittal plane (segmental kyphosis, sagittal vertical axis) or overall complication rate.

Conclusions: Preservation of IVD during the procedure was associated with less blood loss. However, IVD preservation procedures did not show more scoliosis recurrence or deteriorating long-term scoliosis correction outcomes. Thus, removal of HV adjacent IVD for the sake of long-term scoliosis correction outcome at the expense of increasing blood loss is doubtful and deserves further study in pediatric congenital scoliosis caused by hemivertebra.