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Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis
OBJECTIVES: To compare the surgical effect of children with symmetrical screw fixation and asymmetric screw fixation during posterior hemivertebra excision and short‐segment pedicle screw fixation for the treatment of congenital scoliosis (CS). METHODS: A total of 30 children with CS who underwent p...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862179/ https://www.ncbi.nlm.nih.gov/pubmed/33258309 http://dx.doi.org/10.1111/os.12838 |
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author | Wang, Chen Meng, Zhao You, Dian‐ping Zhu, Hua Wang, Fei Liu, Jun‐hang Zhao, Shuo |
author_facet | Wang, Chen Meng, Zhao You, Dian‐ping Zhu, Hua Wang, Fei Liu, Jun‐hang Zhao, Shuo |
author_sort | Wang, Chen |
collection | PubMed |
description | OBJECTIVES: To compare the surgical effect of children with symmetrical screw fixation and asymmetric screw fixation during posterior hemivertebra excision and short‐segment pedicle screw fixation for the treatment of congenital scoliosis (CS). METHODS: A total of 30 children with CS who underwent posterior hemivertebra excision and short‐segment bilateral pedicle screw fixation in our hospital from 2012 to 2018 were retrospectively included and were divided into two groups: symmetric fixation group (n = 18) and asymmetric fixation group (n = 12). The total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, coronal balance, and apical vertebra translation were measured in the coronal plane. The segmental kyphosis, thoracic kyphosis, lumbar lordosis, and sagittal balance were measured in the sagittal plane. RESULTS: Of the 30 children, 28 hemivertebrae were resected. Twenty‐two children had one hemivertebra, three had two hemivertebrae, and five were rib deformities. The average operation time was 268 min (180–420 min). The average blood loss was 291 mL (150–550 mL). The average follow‐up was 21.1 months (12–47 months). For symmetric fixation group and there were significant differences among postoperative and follow‐up parameters including the total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, apical vertebra translation and segmental kyphosis compared with those of preoperative parameters (P < 0.05). The postoperative coronal balance was significantly lower than preoperative coronal balance (P < 0.05). The follow‐up thoracic kyphosis was significantly higher than preoperative and postoperative thoracic kyphosis (P < 0.05). For asymmetric fixation group, the postoperative and follow‐up parameters including the total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, apical vertebra translation, and segmental kyphosis had statistical differences compared with those of preoperative parameters (P < 0.05). The postoperative sagittal balance was significantly higher than preoperative postoperative (P < 0.05). There were no significant differences in the postoperative and follow‐up correction rate and correction loss between the two groups (P > 0.05). There were three complications in 30 children in our study, including two cases who had poor wound healing, and the wound healed smoothly after half a month of sterile dressing change. Postoperative curve progression occurred in one case after T(12) and L(3) hemivertebra resection and thoracic hemivertebra resection was planned again. CONCLUSION: For pedicles which were difficult for screw fixation, adjacent segments can be chosen for screw fixation and it is safe and effective for vertebral pedicles ≤3 without internal fixation. |
format | Online Article Text |
id | pubmed-7862179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-78621792021-02-16 Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis Wang, Chen Meng, Zhao You, Dian‐ping Zhu, Hua Wang, Fei Liu, Jun‐hang Zhao, Shuo Orthop Surg Clinical Articles OBJECTIVES: To compare the surgical effect of children with symmetrical screw fixation and asymmetric screw fixation during posterior hemivertebra excision and short‐segment pedicle screw fixation for the treatment of congenital scoliosis (CS). METHODS: A total of 30 children with CS who underwent posterior hemivertebra excision and short‐segment bilateral pedicle screw fixation in our hospital from 2012 to 2018 were retrospectively included and were divided into two groups: symmetric fixation group (n = 18) and asymmetric fixation group (n = 12). The total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, coronal balance, and apical vertebra translation were measured in the coronal plane. The segmental kyphosis, thoracic kyphosis, lumbar lordosis, and sagittal balance were measured in the sagittal plane. RESULTS: Of the 30 children, 28 hemivertebrae were resected. Twenty‐two children had one hemivertebra, three had two hemivertebrae, and five were rib deformities. The average operation time was 268 min (180–420 min). The average blood loss was 291 mL (150–550 mL). The average follow‐up was 21.1 months (12–47 months). For symmetric fixation group and there were significant differences among postoperative and follow‐up parameters including the total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, apical vertebra translation and segmental kyphosis compared with those of preoperative parameters (P < 0.05). The postoperative coronal balance was significantly lower than preoperative coronal balance (P < 0.05). The follow‐up thoracic kyphosis was significantly higher than preoperative and postoperative thoracic kyphosis (P < 0.05). For asymmetric fixation group, the postoperative and follow‐up parameters including the total main curve, segmental main curve, cranial compensatory curve, caudal compensatory curve, apical vertebra translation, and segmental kyphosis had statistical differences compared with those of preoperative parameters (P < 0.05). The postoperative sagittal balance was significantly higher than preoperative postoperative (P < 0.05). There were no significant differences in the postoperative and follow‐up correction rate and correction loss between the two groups (P > 0.05). There were three complications in 30 children in our study, including two cases who had poor wound healing, and the wound healed smoothly after half a month of sterile dressing change. Postoperative curve progression occurred in one case after T(12) and L(3) hemivertebra resection and thoracic hemivertebra resection was planned again. CONCLUSION: For pedicles which were difficult for screw fixation, adjacent segments can be chosen for screw fixation and it is safe and effective for vertebral pedicles ≤3 without internal fixation. John Wiley & Sons Australia, Ltd 2020-11-30 /pmc/articles/PMC7862179/ /pubmed/33258309 http://dx.doi.org/10.1111/os.12838 Text en © 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Clinical Articles Wang, Chen Meng, Zhao You, Dian‐ping Zhu, Hua Wang, Fei Liu, Jun‐hang Zhao, Shuo Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title | Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title_full | Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title_fullStr | Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title_full_unstemmed | Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title_short | Individualized Study of Posterior Hemivertebra Excision and Short‐Segment Pedicle Screw Fixation for the Treatment of Congenital Scoliosis |
title_sort | individualized study of posterior hemivertebra excision and short‐segment pedicle screw fixation for the treatment of congenital scoliosis |
topic | Clinical Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862179/ https://www.ncbi.nlm.nih.gov/pubmed/33258309 http://dx.doi.org/10.1111/os.12838 |
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