Efficacy and safety of one-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae: A more than 2-year follow-up

•Treating scoliosis due to unbalanced multiple hemivertebrae is challenging.•Hemivertebral resection (one-stage posterior approach) is safe and effective.•Long-term follow-up for complications is needed in skeletally immature patients.

ObjectiveOne-stage posterior hemivertebral resection has been proven to be an effective, reliable surgical option for treating congenital scoliosis due to a single hemivertebra. To date, however, no studies of treating unbalanced multiple hemivertebrae have appeared. This study evaluated the efficacy and safety of one-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae.Patients and methodsAltogether, we studied 15 patients with unbalanced multiple hemivertebrae who had undergone hemivertebral resection using the one-stage posterior approach with at least 2 years of follow-up. Clinical outcomes were assessed radiographically and with the Scoliosis Research Society-22 (SRS-22) score. Related complications were also recorded.ResultsThe mean Cobb angle of the main curve was 62.4° (46°-98°) before surgery and 18.2° (9°-33°) at the most recent follow-up (average correction 73.3%). The compensatory cranial curve was corrected from 28.5° (11°-52°) to 9.1° (0°-30°) (average correction 70.0%). The compensatory caudal curve was corrected from 31.6° (14°-54°) to 6.9°(0°-19°) (average correction 79.1%). The segmental kyphosis/lordosis was corrected from 41.1° (−40° to 98°) to 12.3° (−25° to 41°) (average correction 65.5%). The mean growth rate of the T1-S1 length in immature patients was 9.8 mm/year during the follow-up period. Health-related quality of life (SRS-22 score) had significantly improved. Complications include one wound infection and one developing deformity.ConclusionOne-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae provides good radiographic and clinical outcomes with no severe complications when performed by an experienced surgeon. Longer follow-up to detect late complications is obligatory.