Chinese Journal of Clinical Anatomy >
Anatomy and surgical approaches of medium-to-severe congenital scoliosis caused by hemivertebrae
Received date: 2013-08-12
Online published: 2014-04-21
Objective To study anatomy of imaging technology on medium-to-severe congenital scoliosis caused chiefly by single hemivertebrae and evaluate the early clinical outcome of surgical approaches based on anatomy. Methods A total of 16 cases with medium-to-severe congenital scoliosis underwent X-ray and spiral CT reconstruction preoperatively, which were taken as the basis for surgical approaches, including location and growth potential and type of hemivertebrae, kyphoscoliosis Cobb angle and flexibility of spine. Techniques of posterior osteotomy or posterior osteotomy and anterior bone graft fusion were performed to correct the scoliosis. And clinical outcome of surgical approaches were analyzed. Results All surgeries were finished successfully. The surgical duration was 4.0~8.5 hours (mean, 5.8 hours), and the perioperative bleeding was 500~4000 mL (mean, 1350 mL). There was no occurrence of neurological deficit, infection or deep venous thrombosis. The scoliosis Cobb's angle was (67.8±8.4)° preoperatively, and (25.3±6.8)° postoperatively respectively, the correction rate of being (63.1±6.1)%. The kyphoscoliosis Cobb's angle was (73.5±10.7)°preoperatively, and (29.1±5.6)° postoperatively, the correction rate of being (60.1±6.2)% . Bony fusion was achieved in all patients and no pseudoarthrosis and implant failure occurred after the last follow-up. No obvious correction loss was observed either in coronal or sagittal plane. Conclusions Anatomy of spine are helpful for guidance of surgical program. Posterior surgical correction is a feasible and an effective procedure in the treatment of medium-to-severe congenital scoliosis. Anterior bone graft fusion will be a necessary procedure if adjacent wedge-shaped vertebral bodies are severe.
Key words： Congenital scoliosis; Hemivertebra; Applied anatomy; Correction
LI Bei , TU Yu , WANG Qun-Bei , JUE Yi-Ming , JIAN Bang-Beng . Anatomy and surgical approaches of medium-to-severe congenital scoliosis caused by hemivertebrae[J]. Chinese Journal of Clinical Anatomy, 2014 , 32(2) : 210 -213 . DOI: 10.13418/j.issn.1001-165x.2014
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