Fusionless posterior hemivertebra resection in a 2-year-old child with 16 years follow-up.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
D JeszenszkyL Bognár

Abstract

We present the case of a 2-year-old patient with congenital scoliosis due to a lumbar hemivertebra. The current gold standard treatment of such an abnormality would be hemivertebra resection and short level posterior spinal fusion. However, due to the young age of the patient, we considered that application of a fusionless solution might offer advantages in terms of retaining normal segmental motion and the potential for growth. The incarcerated hemivertebra was resected and the facet joints of the neighbouring vertebrae were joined to create a new functional motion segment and correct the kyphoscoliotic deformity. Transpedicular screws were inserted on the convex side in L2 and L3 and a tension band was applied. 16 years after the surgery, the patient was completely pain-free, motion of the lumbar spine was preserved and the physiological curvatures were maintained. To our knowledge a fusionless surgical solution for the treatment of a hemivertebra has never been described before. Although this is only a single case, the good result with a long follow-up suggests the technique is worthwhile considering when planning the treatment of a lumbar hemivertebra in very young children.

References

Feb 1, 1995·The Journal of Bone and Joint Surgery. American Volume·D C HolteF Denis
Feb 5, 2005·Fetal Diagnosis and Therapy·Israel GoldsteinArie Drugan
Feb 25, 2006·Zeitschrift für Orthopädie und ihre Grenzgebiete·M RufJ Harms

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Citations

Mar 17, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michael Grevitt
Oct 29, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Chunguang ZhouQingquan Kong
Dec 9, 2016·Spine Deformity·Lucas PiantoniErnesto S Bersusky

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