2001 Excision of hemivertebrae in the management of congenital scoliosis

Description: J Bone Joint Surg Br. 2001 May;83(4):496-500. Excision of hemivertebrae in the management of congenital scoliosis involving the thoracic and thoracolumbar spine.Deviren V, Berven S, Smith JA, Emami A, Hu SS, Bradford DS. Department of Orthopaedic Surgery, University of California, San Francisco 94143-0728, USA. We present a study of ten consecutive patients who underwent excision of thoracic or thoracolumbar hemivertebrae for either angular deformity in the coronal plane, or both coronal and sagittal deformity. Vertebral excision was carried out anteriorly alone in two patients. Seven patients had undergone previous posterior spinal fusion. Their mean age at surgery was 13.4 years (6 to 19). The mean follow-up was 78.5 months (20 to 180). The results were evaluated by radiological review of the preoperative, postoperative and most recent follow-up films. The mean preoperative coronal curve was 78.2 degrees (30 to 115) and was corrected to 33.9 degrees (7 to 58) postoperatively, a mean correction of 59%. Preoperative coronal decompensation of 35 mm was improved to 11 mm postoperatively. Seven patients had significant coronal decompensation preoperatively, which was corrected to a physiological range postoperatively. There were no major complications and no neurological damage. We have shown that resection of thoracic and thoracolumbar hemivertebrae can be performed safely, without undue risk of neurological compromise, in experienced hands.