Thoracolumbar Hemivertebrae Resection by Double Approach in a Single Procedure

In Brief Study Design. Retrospective review of patients records with clinical and radiographic assessment. Objective. To evaluate the long-term result of thoracolumbar hemivertebrae resection using a double approach in a single procedure. Summary of Background Data. Thoracolumbar hemivertebrae resection by a combined posterior and anterior approach has been previously described, but this is the largest series of hemivertebrae reported. Methods. From 1987 to 2003, a consecutive series of 34 congenital scoliosis or kyphoscoliosis due to thoracolumbar hemivertebrae were managed by hemivertebra resection using a combined posterior and anterior approach and short anterior and posterior convex fusion in the same day/same anesthesia. Results. The mean age at surgery was 3.5 years. The mean follow-up period was 6.0 years. There was a mean improvement of 69.3% in the segmental curve from a mean angle of 34.8° before surgery to 10.7° at the latest follow-up assessment. The global scoliosis curve improved of 33.4% from 40.4° to 26.9°, respectively. Trunk shift was significantly improved. The mean final kyphosis was within normal values. Conclusions. This procedure is safe and offers a persistent correction with a short segment fusion. Surgery should be performed as early as possible to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions. The long-term results of 34 thoracolumbar hemivertebrae resection using a simultaneous double approach and short anterior and posterior convex fusion is reported. There was a mean improvement of the global scoliosis curve of 33.4% from 40.4° before surgery to 26.9° at the latest follow-up assessment. The procedure is safe.