Lumbosacral Hemivertebrae Resection by Combined Approach

STUDY DESIGN: Retrospective review of patients records with clinical and radiographic assessment. OBJECTIVES: To evaluate the long-term result of lumbosacral hemivertebrae resection using a combined approach. SUMMARY OF BACKGROUND DATA: Lumbosacral hemivertebrae resection by a combined posterior and anterior approach have been previously described, but only one study is concerning such a large series of hemivertebrae. METHODS: From 1980 to 2001, a consecutive series of 17 congenital scolioses due to lumbosacral hemivertebrae were managed by hemivertebrae resection using a combined approach and short anterior and posterior convex fusion. RESULTS: The mean age at surgery was 4.9 years. The mean follow-up period was 7.6 years. One postoperative complication was encountered: a patient had motor deficit and recovery was incomplete. The mean segmental scoliosis curve was 27.5 degrees before surgery, 10.7 degrees after surgery, and 8.9 degrees at the latest follow-up assessment. This represents a mean improvement of 61.1% after surgery and of 67.6% at the latest follow-up. The total main scoliosis curve improved from 28.4 degrees to 12.7 degrees and 11.4 degrees , respectively. It represents a mean improvement of 55.3% and 59.9%, respectively. The mean final lordosis was within normal values. CONCLUSIONS: This procedure offers a persistent correction with a short-segment fusion. The early surgery is able to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.