Comparative Results in Hemivertebrectomy and Fusion Surgery Below and Above 10 Years of Age

Objective:The aim of this study was to present and compare preoperative and postoperative radiologic results and health-related quality of life scores (HRQoL) in patients below and above 10 years who underwent hemivertebrectomy.Materials and Methods: We reviewed 22 patients who underwent posterior hemivertebra resection and fusion for congenital or kyphoscoliosis at a single center.The mean follow-up period was 24.5 months.Patients were equally divided into G1 (below 10 y/o) who underwent shortlevel fixation (SLF) and G2 (above 10 y/o) who underwent SLF or long-level fixation (LLF).Radiological evaluations were performed, and HRQoL questionnaires were examined.Results: G2 exhibited longer fusion (7.2 vs. 2.5), longer surgery (401.3 vs. 218.2minute), higher blood loss (818.8 vs. 263.6mL), and higher blood transfusion (5 vs. 1 unit) compared with G1 (p<0.05).Preoperative Cobb angles were higher in G2 than in G1, and both groups experienced decreased Cobb angles in the early and late postoperative periods (p<0.05).Other examinations included the thoracic kyphosis angle, lumbar lordosis angle, coronal balance, sagittal balance, shoulder balance, and pelvic obliquity, but no significant differences were observed between the groups (p>0.05).In G1, patients' postoperative general health status improved, child and parent satisfaction increased, and activities of daily living increased, but their emotional state worsened (p<0.05).In G2, postoperative pain, physical function, self-image, mental health, and satisfaction with treatment management increased (p<0.05). Conclusion:Hemivertebrectomy is a successful surgical treatment for improving radiological and HRQoL scores both below and above 10 years.We recommend SLF for physiological growth and less fusion in children aged 10 years, but psychological support is crucial to prevent emotional deterioration.LLF offers advantageous radiological results in children aged >10 years but may lead to painful HRQoL scores.