Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children
Abstract Background Congenital scoliosis caused by failure of multiply vertebral segmentation with concave fused rib or unsegmented bar combined with contralateralhemivertebra is usually rigid and produces enormous asymmetric growth. Fusionless techniques have less advantage and come with some compl...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-021-04682-y |
| _version_ | 1819115683941711872 |
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| author | Sheng Zhao Xuhong Xue Kai Li Feng Miao Bin Zhao |
| author_facet | Sheng Zhao Xuhong Xue Kai Li Feng Miao Bin Zhao |
| author_sort | Sheng Zhao |
| collection | DOAJ |
| description | Abstract Background Congenital scoliosis caused by failure of multiply vertebral segmentation with concave fused rib or unsegmented bar combined with contralateralhemivertebra is usually rigid and produces enormous asymmetric growth. Fusionless techniques have less advantage and come with some complications. Paucity of data was reported for children with complex congenital scoliosis using two-staged osteotomy surgery. Methods From 2006 to 2016, 11 patients less than 10 years old undergoing two staged osteotomy surgery for complex rigid congenital scoliosis were retrospectively reviewed. The analysis included age at initial surgery, second surgery and at the latest follow-up, and complications. Changes in coronal major curve, thoracic kyphosis, lumbar lodorsis, apex vertebra translation, T1-T12 length, T1-S1 length, trunk shift, and SVAwere included in radiological evaluation. Results In all, the mean follow-up was 72.5 ± 23.8 (42 to 112) months. The mean flexibility of the spine was 17.4 and 17.8 % before two surgeries. The mean age at the initial surgery was 6.6 ± 2.6 (2.5–10) years. The mean fusion level was 4.6 ± 1.3 (2 to 6) segments. The mean scoliosis improved from 67.4° to 23.7° after initial surgery and was 17.4° at the latest follow-up. The average increase of T1-S1 length was 0.92 cm per year. No patients had neurological complications. Conclusions Two-staged osteotomy surgery including hemivertebrae resection or Y-shaped osteotomy can achieve good radiological and clinical outcomes without severe complications. This procedure can be an option of treatment for complex congenital scoliosis. |
| first_indexed | 2024-12-22T05:05:06Z |
| format | Article |
| id | doaj.art-f28231ce1f0f42c99f00a724c526046f |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-22T05:05:06Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-f28231ce1f0f42c99f00a724c526046f2022-12-21T18:38:08ZengBMCBMC Musculoskeletal Disorders1471-24742021-09-012211910.1186/s12891-021-04682-yTwo-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old childrenSheng Zhao0Xuhong Xue1Kai Li2Feng Miao3Bin Zhao4Department of Orthopedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopedics, The Second Hospital of Shanxi Medical UniversityDepartment of Orthopedics, The Second Hospital of Shanxi Medical UniversityAbstract Background Congenital scoliosis caused by failure of multiply vertebral segmentation with concave fused rib or unsegmented bar combined with contralateralhemivertebra is usually rigid and produces enormous asymmetric growth. Fusionless techniques have less advantage and come with some complications. Paucity of data was reported for children with complex congenital scoliosis using two-staged osteotomy surgery. Methods From 2006 to 2016, 11 patients less than 10 years old undergoing two staged osteotomy surgery for complex rigid congenital scoliosis were retrospectively reviewed. The analysis included age at initial surgery, second surgery and at the latest follow-up, and complications. Changes in coronal major curve, thoracic kyphosis, lumbar lodorsis, apex vertebra translation, T1-T12 length, T1-S1 length, trunk shift, and SVAwere included in radiological evaluation. Results In all, the mean follow-up was 72.5 ± 23.8 (42 to 112) months. The mean flexibility of the spine was 17.4 and 17.8 % before two surgeries. The mean age at the initial surgery was 6.6 ± 2.6 (2.5–10) years. The mean fusion level was 4.6 ± 1.3 (2 to 6) segments. The mean scoliosis improved from 67.4° to 23.7° after initial surgery and was 17.4° at the latest follow-up. The average increase of T1-S1 length was 0.92 cm per year. No patients had neurological complications. Conclusions Two-staged osteotomy surgery including hemivertebrae resection or Y-shaped osteotomy can achieve good radiological and clinical outcomes without severe complications. This procedure can be an option of treatment for complex congenital scoliosis.https://doi.org/10.1186/s12891-021-04682-ycongenital scoliosisrib deformityhemivertebraeY-shaped osteotomytwo-staged surgery |
| spellingShingle | Sheng Zhao Xuhong Xue Kai Li Feng Miao Bin Zhao Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children BMC Musculoskeletal Disorders congenital scoliosis rib deformity hemivertebrae Y-shaped osteotomy two-staged surgery |
| title | Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| title_full | Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| title_fullStr | Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| title_full_unstemmed | Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| title_short | Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| title_sort | two staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children |
| topic | congenital scoliosis rib deformity hemivertebrae Y-shaped osteotomy two-staged surgery |
| url | https://doi.org/10.1186/s12891-021-04682-y |
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