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Lumbar Hemivertebra Resection
Gérard Bollini, MD, PhD1; Pierre-Louis Docquier, MD2; Elke Viehweger, MD1; Franck Launay, MD1; Jean-Luc Jouve, MD, PhD1
1 Department of Paediatric Orthopedic Surgery, Hôpital Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille CEDEX 5, France. E-mail address for G. Bollini: gerard.bollini@ap-hm.fr
2 Department of Paediatric Orthopedic Surgery, Cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgium. E-mail address: pierre-louis.docquier@clin.ucl.ac.be
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Hôpital Timone Enfants, Marseille, France

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 May 01;88(5):1043-1052. doi: 10.2106/JBJS.E.00530
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Abstract

Background: A single lumbar hemivertebra can be expected to cause progressive scoliosis. The aim of this study was to evaluate the results of a lumbar hemivertebra resection and short-segment fusion through a combined posterior and anterior approach.

Methods: From 1987 to 2002, a consecutive series of twenty-one patients with congenital scoliosis or kyphoscoliosis due to a lumbar hemivertebra were managed by resection of the hemivertebra through a combined posterior and anterior approach and with the use of a short anterior and posterior convex-side fusion.

Results: The mean age at the time of surgery was 3.3 years (range, twelve months to 10.2 years). The mean followup period was 8.6 years. There was a mean improvement of 71.4% in the segmental scoliosis curve from a mean angle of 32.9° before surgery to 9.4° at the time of the latest follow-up assessment, and a mean improvement of 63.9% in the global scoliosis curve from 34.1° to 12.3°. The mean final lordosis was within normal values.

Conclusions: Excision of a lumbar hemivertebra is safe and provides stable correction when combined with a short-segment fusion. Surgery should be performed as early as possible to avert the development of severe local deformities and prevent secondary structural deformities that would require a more extensive fusion later.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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