Emerging S-shaped curves in congenital scoliosis after hemivertebra resection and short segmental fusion

Abstract Background Context Posterior hemivertebra resection with short fusion has gradually become the mainstream treatment for the congenital scoliosis due to single fully segmented hemivertebra. A kind of unexpected emerging S-shaped scoliosis was found secondary to this surgery, and that has not...

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Bibliographic Details
Published in:The spine journal 2016-10, Vol.16 (10), p.1214-1220
Main Authors: Yang, Xi, M.D, Song, Yueming, M.D, Liu, Limin, M.D, Zhou, Chunguang, M.D, Zhou, Zhongjie, M.D, Wang, Lei, M.D, Wang, Liang, M.D
Format: Article
Language:English
Subjects:
Adolescent
Child
Complication
Congenital scoliosis
Female
Hemivertebra resection
Humans
Male
Orthopedics
Posterior-only approach
Postoperative Complications
Reoperation
Revision surgery
Scoliosis - etiology
Scoliosis - surgery
Short fusion
Spinal Fusion - adverse effects
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Summary:Abstract Background Context Posterior hemivertebra resection with short fusion has gradually become the mainstream treatment for the congenital scoliosis due to single fully segmented hemivertebra. A kind of unexpected emerging S-shaped scoliosis was found secondary to this surgery, and that has not been reported yet. Purpose To analyze the possible pathogenesis, clinical feature and treatment of the emerging S-shaped scoliosis after posterior hemivertebra resection and short fusion. Study Design Retrospective case series. Patient Sample 128 patients. Outcome Measures Preoperative and postoperative whole spine radiographs were used to measure the Cobb angle of main curve, compensatory curve and emerging curves. And the hemivertebra location, the fused segment, the apical and ending vertebrae of postoperative emerging curve (and preoperative compensatory curves) were assessed. Methods Both the demographics and radiographic data were reviewed. Postoperative emerging scoliosis was defined as the curve with an increasing angle of 20° and an apical vertebra locating at least 2 levels away from fusion region. Results 9 of 128 patients (7%) showed the postopertive emerging S-shaped scoliosis. The mean age was 11.4 years old. The mean main curve was 36.1±14.4° preoperatively and been significantly corrected to 6.9±6.1° (p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2016.06.006