Surgical Outcomes in Children Under 10 Years Old in The Treatment of Congenital Scoliosis Due To Single Nonincarcerated Thoracolumbar Hemivertebra: According To The Age At Surgery
Abstract Purpose Hemivertebra is one of the common pathogenesis of congenital scoliosis. The timing of operation is undefined. Our study compared the surgical outcomes in children under age 10 years with scoliosis due to single nonincarcerated thoracolumbar hemivertebra according to the age at surgery. Methods From January 2009 to August 2017, we retrospectively investigated 34 consecutive cases of congenital scoliosis treated by posterior hemivertebra resection and fusion with pedicle screw fixation. All cases were devided into two groups according to the age at surgery and followed-up for at least 2 years. Group 1 (≤ 5 years old), and group 2 (5 to 10 years old). Results The mean Cobb angle of the main curve was improved from 48.58° to 15.53° (68.05%) in group 1, and from 43.73° to 11.33°(75.43%) in group 2. The segmental curve was improved from 44.16° to 11.53°(74.64 %) in group 1, and the segmental curve was consistent with the main curve in group 2. The mean segmental kyphosis was improved from 27.50° to 8.42°(67.40%) in group 1, and from 29.00° to 5.00° (84.73%) in group 2. 5 patients developed distal adding-on and 4 patients were found proximal junctional kyphosis during the follow up. Conclusions Not all the deformities caused by single nonincarcerated thoracolumbar hemivertebra would progress greatly with the spinal growth. A limited delayed surgery after 5 years but before 10 years of age with close follow-up can achieve good results, the occurrence of distal adding-on might be reduced, although it may need more than two segments fusion.