Simultaneous anterior and posterior hemivertebra excision.

The operative treatment of congenital scoliosis secondary to hemivertebra may involve in situ spinal epiphysiodesis, in situ fusion, or hemivertebra excision. The technique described in this paper, simultaneous anterior and posterior resection of the hemivertebra and correction of deformity with posterior instrumentation, has evolved from many different surgical methods used by the senior author in the past. This series of 11 patients describes the resection technique, degree of deformity correction, and complications encountered with this approach to a very difficult clinical problem. The preoperative mean age of the patients at the time of surgery was 18 months (range, 1 month-30 months), and preoperative curves averaged 47 degrees (range, 30 degrees-80 degrees). Immediate postoperative curves averaged 13 degrees (range, 1 degree-40 degrees), and at a mean of 28 months followup the curves averaged 14 degrees (range, 1 degree-47 degrees). One patient experienced transient left leg weakness. There were no long term neurologic injuries and no other surgical complications.