The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up
Abstract Background Previous studies have reported favorable short-term outcomes after posterior-only hemivertebra resection and short fusion in patients with LSHV. However, there is a paucity of data evaluating the long-term outcomes following this procedure. The aim of the study is to evaluate the...
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-019-1482-5 |
| _version_ | 1817991955876937728 |
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| author | Yu Wang Zhen Liu Changzhi Du Benlong Shi Xu Sun Bin Wang Zezhang Zhu Yong Qiu |
| author_facet | Yu Wang Zhen Liu Changzhi Du Benlong Shi Xu Sun Bin Wang Zezhang Zhu Yong Qiu |
| author_sort | Yu Wang |
| collection | DOAJ |
| description | Abstract Background Previous studies have reported favorable short-term outcomes after posterior-only hemivertebra resection and short fusion in patients with LSHV. However, there is a paucity of data evaluating the long-term outcomes following this procedure. The aim of the study is to evaluate the radiological outcomes following posterior-only hemivertebra resection and short fusion for the treatment of congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) with a minimum of a 5-year follow-up. Methods A total of 23 patients treated with one-stage posterior-only LSHV resection and short fusion with a minimum of a 5-year follow-up were reviewed. Radiographic parameters including the Cobb angles of the lumbosacral curve and compensatory curve, the upper instrumented vertebra (UIV) tilt, and trunk shift were measured. The complications were recorded accordingly. Results The mean duration of follow-up was 88.6 ± 28.5 months, and the average age at surgery was 7.8 ± 3.5 years. Fusion levels averaged 3.0 ± 0.7 segments. The lumbosacral curve was corrected from 30.7 ± 10.4° to 6.7 ± 7.1° after surgery (P < 0.001), 7.3 ± 6.1° 2 years after surgery, and 8.1 ± 7.0° at the last follow-up. The compensatory curve was spontaneously corrected from 23.7 ± 9.4° before surgery to 8.3 ± 5.2° after surgery (P < 0.001). However, the angle slightly increased to 9.0 ± 4.8° 2 years after surgery and to 9.6 ± 6.4° at the last follow-up. Trunk shift was improved from 27.3 ± 8.6 mm before surgery to 11.7 ± 9.4 mm after surgery, and it decreased to 10.8 ± 8.2 mm 2 years after surgery and 10.4 ± 8.8 mm at the last follow-up. One patient experienced transient neurologic deficits after surgery. One patient was observed to have screw loosening at 1-year follow-up and received revision surgery. Conclusion One-stage posterior-only hemivertebra resection with short fusion is an effective procedure for LSHV, and the correction can be well maintained during longitudinal follow-up. Great attention should be paid to the restoration of lumbosacral horizontalization. |
| first_indexed | 2024-04-14T01:20:09Z |
| format | Article |
| id | doaj.art-ea0500d22bfe4d5596ecbdac992d32a2 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T01:20:09Z |
| publishDate | 2019-12-01 |
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| spelling | doaj.art-ea0500d22bfe4d5596ecbdac992d32a22022-12-22T02:20:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-12-011411710.1186/s13018-019-1482-5The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-upYu Wang0Zhen Liu1Changzhi Du2Benlong Shi3Xu Sun4Bin Wang5Zezhang Zhu6Yong Qiu7Department of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityDepartment of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical UniversityAbstract Background Previous studies have reported favorable short-term outcomes after posterior-only hemivertebra resection and short fusion in patients with LSHV. However, there is a paucity of data evaluating the long-term outcomes following this procedure. The aim of the study is to evaluate the radiological outcomes following posterior-only hemivertebra resection and short fusion for the treatment of congenital scoliosis (CS) secondary to lumbosacral hemivertebra (LSHV) with a minimum of a 5-year follow-up. Methods A total of 23 patients treated with one-stage posterior-only LSHV resection and short fusion with a minimum of a 5-year follow-up were reviewed. Radiographic parameters including the Cobb angles of the lumbosacral curve and compensatory curve, the upper instrumented vertebra (UIV) tilt, and trunk shift were measured. The complications were recorded accordingly. Results The mean duration of follow-up was 88.6 ± 28.5 months, and the average age at surgery was 7.8 ± 3.5 years. Fusion levels averaged 3.0 ± 0.7 segments. The lumbosacral curve was corrected from 30.7 ± 10.4° to 6.7 ± 7.1° after surgery (P < 0.001), 7.3 ± 6.1° 2 years after surgery, and 8.1 ± 7.0° at the last follow-up. The compensatory curve was spontaneously corrected from 23.7 ± 9.4° before surgery to 8.3 ± 5.2° after surgery (P < 0.001). However, the angle slightly increased to 9.0 ± 4.8° 2 years after surgery and to 9.6 ± 6.4° at the last follow-up. Trunk shift was improved from 27.3 ± 8.6 mm before surgery to 11.7 ± 9.4 mm after surgery, and it decreased to 10.8 ± 8.2 mm 2 years after surgery and 10.4 ± 8.8 mm at the last follow-up. One patient experienced transient neurologic deficits after surgery. One patient was observed to have screw loosening at 1-year follow-up and received revision surgery. Conclusion One-stage posterior-only hemivertebra resection with short fusion is an effective procedure for LSHV, and the correction can be well maintained during longitudinal follow-up. Great attention should be paid to the restoration of lumbosacral horizontalization.https://doi.org/10.1186/s13018-019-1482-5Congenital scoliosisLumbosacralHemivertebra resectionPosterior-onlyInstrumentationFusion |
| spellingShingle | Yu Wang Zhen Liu Changzhi Du Benlong Shi Xu Sun Bin Wang Zezhang Zhu Yong Qiu The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up Journal of Orthopaedic Surgery and Research Congenital scoliosis Lumbosacral Hemivertebra resection Posterior-only Instrumentation Fusion |
| title | The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up |
| title_full | The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up |
| title_fullStr | The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up |
| title_full_unstemmed | The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up |
| title_short | The radiological outcomes of one-stage posterior-only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra: a minimum of 5 years of follow-up |
| title_sort | radiological outcomes of one stage posterior only hemivertebra resection and short segmental fusion for lumbosacral hemivertebra a minimum of 5 years of follow up |
| topic | Congenital scoliosis Lumbosacral Hemivertebra resection Posterior-only Instrumentation Fusion |
| url | https://doi.org/10.1186/s13018-019-1482-5 |
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