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Journals / Journal of Turkish Spinal Surgery / 2014 / Cilt: 25 - Sayı: 2

Results of complete hemivertebrae excision with only posterior aproach followed by circumferential fusion and posterior instrumentation in pa- tients with fully segmented and unincarsered hemivertebra

Tam segmente ve kilitlenmemiş hemivertebralı hastalarda sadece posterior yaklaşımla tam hemivertebrektomi, sirkümferensiyal füzyon posterior kısa enstrümantasyon sonuçları

Doğaç KARAGÜVEN
İ. Teoman BENLİ
Mehmet AYDOĞAN
Pages
87–96
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: In the view of these data, it is concluded that only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation was effective and safe technique for the unlocked full-segmented hemivertebra in all vertebral region.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To evaluate the results of surgical treatment in patients with unlocked full-segmented hemivertebra treated with only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation.
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Key Findings & Data:Study Design: Twelve patients with a mean age of 9,4 ± 5,4 (2-14) years were included in the study (6 girls and 6 boys).
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Conclusion & Impact:Conclusion: In the view of these data, it is concluded that only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation was effective and safe technique for the unlocked full-segmented hemivertebra in all vertebral region.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: To evaluate the results of surgical treatment in patients with unlocked full-segmented hemivertebra treated with only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation. Study Design: Twelve patients with a mean age of 9,4 ± 5,4 (2-14) years were included in the study (6 girls and 6 boys). The mean duration of follow up was 59,4 ± 39,6 (24-132) months. Diagnosis of Type – IA hemivertebra was established by clinical, radiological, CT, and MRI evaluation. In all patients, only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation were applied. Frontal and sagittal plane analysis of radiograms obtained preoperatively, postoperatively, and after a period of minimum 2 years was performed. The balance was analyzed clinically and radiologically by the measurement of the lateral trunk shift (LT). Results: The mean preoperative Cobb angle was 55,5° ± 23,4°, and postoperatively a mean correction rate of 89,4 ± 14,4 % was obtained in the main curves (p: 0.00). The mean preoperative Cobb angle of the secondary curves was 38,9° ± 16,1° and postoperatively a mean correction rate of 88,9 ± 11,1 % was obtained in the main curves (p: 0.00). In the last control visit, mean loss of correction was 3,2° ± 3.3°. Local segmenter kyphosis was decreased from 24,4° ± 14,9° to 7,7° ± 5,7. Mean trunk shift (LT) of the patients was corrected in all patients (Preoperative LT: 3,3 ± 2,1 cm; postoperative LT: 0,7 ± 0,4 cm). Circumferential fusion could be achieved in all cases. No neurological complication developed, the only complication was delayed wound healing. Conclusion: In the view of these data, it is concluded that only posterior approach hemivertebrectomy, circumferential fusion and posterior segmenter pedicular screw instrumentation was effective and safe technique for the unlocked full-segmented hemivertebra in all vertebral region.

Özet

Amaç: Sadece posterior girişimle total hemivertebra eksizyo- nu ve segmenter pediküler vidalarla posterior enstrümantas- yonunu etkinliği ve güvenirliğini araştırılması amaçlanmıştır. Hastalar ve Metot: Bu çalışmada ortalama yaşları 9,4 ± 5,4 (2- 14) olup 6’sı erkek, 6’sı kız 12 hemivertebralı hastaya sadece posterior girişimle total hemivertebra eksizyonu ve segmenter pediküler vidalarla posterior enstrümantasyon ve sirkümfe- ransiyel füzyon uygulanmış ve ortalama 59,4 ± 39,6 (24-132) ay takip edilmiştir. Hastaların tamamına intraoperatif nöral mo- nitorizasyon kullanılmıştır. Hastaların ana ve kompenzatuvar eğrilikleri ile lokal kifoz açıları ve lateral gövde kayması değer- lendirilerek, preoperatif, postoperatif ve son kontrol değerleri karşılaştırılmıştır. Sonuçlar: Ana eğriliklerin ortalama preoperatif Cobb açıları 55,5° ± 23,4° olup, postoperatif istatistikî olarak anlamlı ola- cak şekilde % 89,4 ± 14,4 korreksiyon sağlanarak ortalama 15,5°±11,4°’e indiği belirlenmiştir (p:0,00, t:7,1). Kompenzatu- var eğrilikler preoperatif ortalama 38,9° ± 16,1° iken % 88,9 ± 11,1 düzelme sağlanarak 9,3° ± 8,8°’ye düşmüştür. Lokal kifoz açısı ortalama 24,4° ± 14,9° iken 7,7° ± 5,7’ye inmiştir. Hem kompenzatuvar eğriliklerde hem de lokal kifoz açısındaki dü- zelme istatistiki olarak anlamlı bulunmuştur (p 0,05, t:1,2). Ortalama preoperatif LT değeri 3,3 ± 2,1 cm iken postoperatif 0,7 ± 0,4 cm’ye inmiş (p:0,00) ve tüm hastalarda postoperatif denge tam olarak sağ- lanmıştır. Son kontrollerde gövde kayma değerlerinin değiş- mediği ve dengenin tüm hastalarda korunduğu belirlenmiş- tir. Hastaların hiç birinde nörolojik defisit olmamıştır. Ayrıca postoperatif erken ve geç komplikasyona rastlanmamıştır. Hastaların tamamında sirkümferansiyel füzyon oluştuğu be- lirlenmiştir. Sonuç: Bu çalışmanın verileri ışığı altında sadece posterior gi- rişimle total hemivertebra eksizyonu ve segmenter pediküler vidalarla posterior enstrümantasyon uygulaması ile yüksek oranda düzeltme ve sirkümferansiyel füzyonun sağlandığı, yöntemin etkin ve güvenli olduğu fikri elde edilmiştir.

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Cite This Article

KARAGÜVEN, D., BENLİ, İ. T., AYDOĞAN, M. (2014). Results of complete hemivertebrae excision with only posterior aproach followed by circumferential fusion and posterior instrumentation in pa- tients with fully segmented and unincarsered hemivertebra. Journal of Turkish Spinal Surgery, Cilt: 25 - Sayı: 2, 87–96. https://ajindex.com/articles/271386

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