The Journal of Bone and Joint Surgery (American). 2006;88:1043-1052.
doi:10.2106/JBJS.E.00530
© 2006 The Journal of Bone and Joint Surgery, Inc.
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Lumbar Hemivertebra Resection

Gérard Bollini, MD, PhD1, Pierre-Louis Docquier, MD2, Elke Viehweger, MD1, Franck Launay, MD1 and 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{at}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{at}clin.ucl.ac.be

Investigation performed at Hôpital Timone Enfants, Marseille, France

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.

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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