Long-term results of hemivertebra excision: How does the spine behave after the peak of puberty?

Piantoni, Lucas; Tello, Carlos; Remondino, Rodrigo; Moyano, Carlos Alberto; Wilson, Ida A. Francheri; Galaretto, Eduardo; Bersusky, Ernesto; Noël, Mariano A.

doi:10.1007/s43390-020-00198-y

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…This suggests that the inhibitory effect of internal xation on vertebral development is relatively small. The vertebral bodies within the xed segment also grew during the follow-up period, which might be the result of intact vertebral periosteum and at least one intact growth plate on either side 14 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Spinal Growth After Posterior Hemivertebra Resection and Short Segment Fusion in Children

Zhang

Wang

2023

Preprint

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In order to evaluate the corrective effect of posterior hemivertebra resection and short-segment fusion surgery on pediatric patients and to assess the impact of short-segment fixation surgery on vertebral development during follow-up, a retrospective analysis was performed on 28 pediatric patients who underwent posterior hemivertebra resection surgery. The corrective effect was evaluated by comparing the preoperative, postoperative, and final follow-up Cobb angle, upper and lower compensatory curves and trunk balance. Meanwhile, the vertebral and spinal canal diameters of instrumented vertebrae and adjacent noninstrumented vertebrae were measured and compared between preoperative and final follow-up to assess the vertebral and spinal canal development. The correction rate of main curve Cobb angle was 72.2%. The estimated mean vertebral volume of the instrumented vertebra was slightly lower than that of the unfused segment at the final follow-up, but the difference was not statistically significant. The growth rate of the spinal canal during follow-up was much smaller than that of the vertebral body. Although internal fixation surgery might have a slight inhibitory effect on vertebral development within the fused segment in younger patients, it does not cause iatrogenic spinal canal stenosis or neurological dysfunction. Posterior hemivertebra resection and short-segment fusion surgery are safe and effective.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Spinal Growth After Posterior Hemivertebra Resection and Short Segment Fusion in Children

Zhang

Wang

2023

Preprint

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“…In the pediatric spine pedicle screws have shown to be safe and no spinal stenosis has been reported. 29 Nevertheless, in a series of 27 children who underwent two-level HV resection and short-segment posterior spinal instrumentation, Piantoni et al 30 found that the youngest patients were more likely to develop trunk imbalance after the peak of puberty. They concluded that this spinal imbalance showed minimal clinical signs or symptoms and no further surgery was needed.…”

Section: Discussionmentioning

confidence: 99%

Hemivertebra Resection in Small Children. A Literature Review

Frank

Piantoni

Tello

et al. 2022

Global Spine Journal

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Study design Systematic review. Objective To evaluate the lowest possible age to resect an HV in very young patients with a congenital deformity. Methods We sought to retrieve all studies reporting age at HV excision in patients with congenital scoliosis. Studies written in English were included. No publication date restrictions were imposed. A search of the PubMed and LiLacs databases was conducted. Additionally, a hand search was performed to supplement the database search. Results We found 140 articles. Twenty two studies were included into the final assessment. There was considerable heterogeneity in the included studies, both regarding age and the surgical techniques used. There was also a broad spectrum of recommendations regarding suggested age for treatment. The youngest patient undergoing resection and fusion was 3 months of life at the time of surgery. Conclusion How young a patient could and should be submitted to HV resection surgery is still a matter of debate in the literature. Prophylactic surgery might be a proper treatment for young children with congenital scoliosis before malformation becomes a deformity, adding no additional neurological, vascular, or anesthesia-related complications. The defect can be treated early while the deformity is treated late.

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“…Cervical or thoracic hemivertebra are associated with a higher risk of spinal cord abnormalities and, therefore, with a poorer outcome 1. Surgical resection of the affected segment followed by posterior spinal fusion is the most common therapy for hemivertebra and has had promising results 6–8…”

Section: Descriptionmentioning

confidence: 99%