Analysis of the length of fixation during hemivertebra resection. A monocentric retrospective cohort

Abstract

Background: We aimed at reviewing results of surgical correction of spinal deformity due to hemivertebra with regard to the age, severity of deformity and length of instrumentation.Methods. Study comprised 117 patients with congenital spinal deformity treated between 2010 and 2018. Patients’ aged 1 to 18 years. Mean follow-up was 3 years (1 to 8). Posterior approach was used in all cases. Patients were subdivided into 4 groups.Result:Unilateral mono-segmental fixation (Group I) for 15 children with mean age of 48.3 months. Cobb angle for scoliosis and kyphosis were 31.10 + 6.40 and 29.3° + 11.90 corrected to 7.80 + 6.80 and 4.70 + 4.00 respectively. Blood loss was 213.6 mL. Operating time was 165 minutes.Bilateral mono-segmental fixation (Group II) for 24 patients with mean age of 53.1 months. Cobb angle for scoliosis and kyphosis were 32.5° + 8.60 and 30.9° + 4.30 corrected to 5.30 + 2.80 and 0.20 + 11.60 respectively. Blood loss was 215.4 mL. Operating time was 160.5 minutes.Bilateral three-segmental fixation (Group III) for 29 patients with mean age of 78.2 months. Cobb angle for scoliosis and kyphosis were 36.6° + 10.60 and 37.6° + 14.60 corrected to 6.20 + 6.10 and 5.00 + 5.20 respectively. Blood loss was 342.7 mL. Operating time was 197.0 minutes.Bilateral poly-segmental fixation (Group IV) for 49 children with mean age of 112.7 months. Cobb angle for scoliosis and kyphosis were 40.2° + 14.80 and 58.2° + 35.60 corrected to 10.70 + 9.60 and 10.70 + 10.30 respectively. Blood loss was 549.3 mL. Operating time was 288.8 minutes.Conclusion: Choice of spinal fixation technique and the length of fixation were determined on the basis of patient’s age, magnitude of the deformity and concomitant vertebral abnormalities.