Posterior hemivertebra resection in the treatment of congenital upper thoracic deformity caused by hemivertebra

English Keywords:Upper thoracic  Spinal deformity  Hemivertebra resection  Internal fixation

English Abstract:

  【Abstract】 Objective：To evaluate the outcome of surgical treatment for congenital upper thoracic deformity. Method：There were 8 consecutive cases，4 males and 4 females，with the average age at surgery was 13 years ranging from 11 to 15 years.All patients had upper thoracic kyphosis and scoliosis，3 patients with neurologic deficit due to severe spinal deformity.Posterior hemivertebra resection and internal fixation was performed in all cases.Long cassette standing radiographs were taken before and after surgery and at the final follow-up.Correction of scoliosis，kyphosis，neurologic outcomes（JOA scores） and operative complications were recorded and analyzed.Result：The average follow-up was 22.8 months ranging from 6 to 50 months.The average operative time was 278min with a mean 1787ml of blood loss.The average fusion segments were 8.5，ranging from 4 to 11 segments.The scoliosis was corrected averagely from 45.5° to 14.4°.The kyphosis was corrected averagely from 47.9° to 21.6°.The average preoperative JOA score was 5 points，which was improved to 8 points at the final follow-up.Complications included rod broken in 1 case of domino connector extending between 3.5mm and 5.5mm rods.Conclusion：Posterior hemivertebra resection and internal fixation is a reasonable surgical option for congenital upper thoracic deformity caused by hemivertebra.