Introduction: A single lumbar hemivertebra can result in a progressive spinal deformity with devastating consequences. Total resection of these hemivertebrae is ideal for correcting these deformities and several alternatives were suggested including anterior and/or posterior approaches. The aim of this study is to evaluate the clinical and radiographic outcome of single stage vertebral column resection (VCR) in children less than 10 years old.
Methods: The study was performed between 2000 and 2008 and included 31 patients with a lumbar hemivertebra. The average age was 8 years (range, 6 - 9.5 years). VCR involved laminectomy, excision of the pedicle and hemivertebra, and curettage of both end plates; the gap created was filled with morselized cancellous bone. Short segment posterior instrumentation was performed; the gap was gently closed by compression over the pedicle screws and the remaining autograft bone was placed in the posterolateral gutter.
Results: Patients were followed-up for an average of 5.5 years (range 2 – 8 years). The operative time had an average of 235 min (range, 200 – 275 minutes) and the average blood loss was 470 cc (range, 230 - 830 cc). The scoliotic deformity corrected from an average of 43° to an average of 4° postoperatively and an average of 6° at final follow up; kyphosis corrected from an average of 34° to an average of 5° postoperatively and an average of 7° at final follow up. There were no vascular injuries, neurologic insult, implant failure or crank shafting.
Conclusion: Single stage posterior VCR with short segment pedicle screw instrumentation is a safe, efficient alternative that offers excellent correction in both sagittal and coronal planes without the need for anterior surgery.
قسم البحث
مجلة البحث
المؤتمر السنوى للجمعية لجراحى العظام AAOSالمنعقد بمدينة نيواورلينز
المشارك في البحث
تصنيف البحث
3
سنة البحث
2014
ملخص البحث