The results of thoracic and lumbar hemivertebrae resection by a dorsal pedicular approach in children

Does the Fixation Span Impact on Results of Surgical Correction of Pediatric Congenital Spine Deformities? Analysis of a Monocentric Cohort

“…[20,21] Radical pedicular hemivertebra excision within the range of endplates of adjacent vertebrae (PVCR) and monosegmental bilateral transpedicular xation with acute deformity correction was shown to be effective among correction techniques employed for preschool children aged from 1 to 3 years with single, two or more hemivertebrae located between two segments in addition to accompanying spine pathology that requires no surgical correction, with local major curve without structural compensatory curves. [22] The practice provides comparable results of deformity correction of 27.2° of baseline curve, signi cant reduction in blood loss (215.4 mL) in comparison to group III (342.7 mL Р=0.018) and group IV (549.3 mL Р 0.000), minimal operating time of 160.5 minutes in comparison to group III (200.6 min. Р=0.077) and group IV (288.8 mL Р 0.000) with good long-term follow-up (loss of correction 2.2°).…”

“…[23,24] Surgical treatment is indicated for the patients including radical hemivertebra excision within the range of endplates of adjacent vertebral arches combined with posterior bilateral pedicular xation two segments cranial and caudal to the apex of the curve and acute correction of the physiological curves (three segmental xation). [22,25,26,27] The method provided excellent results of deformity correction with comparable blood loss and operating time, good long-term follow-up (loss of correction for scoliosis 0.6°a nd for kyphosis -2.1°). [22,25,26,27] More aggressive technique is indicated for severe deformity of adjacent segments employing vertebrectomy and resection of adjacent segments PSO or VCR types (Schwab grade 4 and 5) and repair of defect of anterior column with mesh implant that constitutes the supporting point for reclination manoeuvre during deformity correction.…”

“…[22,25,26,27] The method provided excellent results of deformity correction with comparable blood loss and operating time, good long-term follow-up (loss of correction for scoliosis 0.6°a nd for kyphosis -2.1°). [22,25,26,27] More aggressive technique is indicated for severe deformity of adjacent segments employing vertebrectomy and resection of adjacent segments PSO or VCR types (Schwab grade 4 and 5) and repair of defect of anterior column with mesh implant that constitutes the supporting point for reclination manoeuvre during deformity correction. [28] Radical excision of the leading anomaly or multiple anomalies and polysegmental transpedicular screw xation is practical for middle childhood (7 to 11 years old) and adolescences (12 to 17-18 years old) with extensive deformity and structural compensatory curves but the procedure is associated with greater blood loss and operating time.…”

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

“…[20,21] Radical pedicular hemivertebra excision within the range of endplates of adjacent vertebrae (PVCR) and bilateral monosegmental transpedicular xation with acute deformity correction was shown to be effective among correction techniques employed for preschool children aged from 1 to 3 years with single, two or more hemivertebrae located between two segments in addition to accompanying spine pathology that requires no surgical correction, with local major curve without structural compensatory curves. [22] The practice provides comparable results of deformity correction of 27.2° of baseline curve, signi cant reduction in blood loss (215.4 mL) in comparison to group III (342.7 mL Р=0.018) and group IV (549.3 mL Р 0.000), minimal operating time of 160.5 minutes in comparison to group III (200.6 min. Р=0.077) and group IV (288.8 mL Р 0.000) with good long-term follow-up (loss of correction 2.2°).…”

“…xation two segments cranial and caudal to the apex of the curve and acute correction of the physiological curves (three segmental xation). [22,25,26,27] The method provided excellent results of deformity correction with comparable blood loss and operating time, good long-term follow-up (loss of correction for scoliosis 0.6° and for kyphosis 2.1°). [22,25,26,27] More aggressive technique is indicated for severe deformity of adjacent segments employing vertebrectomy and resection of adjacent segments PSO or VCR types (Schwab grade 4 and 5) and repair of defect of anterior column with mesh implant that constitutes the supporting point for reclination maneuver during deformity correction.…”