One-stage posterior-only radical hemivertebra resection and short-segment fusion for congenital cervicothoracic scoliosis: a cohort study.

BACKGROUND

Congenital cervicothoracic scoliosis (CTS) caused by hemivertebra poses surgical challenges. Evidence regarding the efficacy and safety of one-stage posterior-only radical hemivertebra resection in this region remains limited.

METHOD: A retrospective cohort study was carried out. Patients who had undergone one-stage, posterior-only radical hemivertebra resection for congenital CTS between January 2018 and March 2022, with a minimum follow-up period of 2 years, were included, and these patients had CTS resulting from cervicothoracic hemivertebra. Data on Demographic characteristics, radiological measurements, surgical details, health-related quality of life, as well as postoperative complications were collected.

RESULTS

This study included 19 CTS patients undergoing one-stage posterior-only hemivertebra resection with short fusion. Mean surgical age was 11.47 ± 3.91 years, with 33.79 ± 15.12 months' follow-up. Preoperative local Cobb angle significantly decreased after surgery (50.20°±15.97°to 20.87°±11. 89°, P < 0.001). Segmental kyphosis reduced from 31.21°±9.99° to 16.40°±7.99° (P < 0.001). Cervical balance parameters (T1 tilt, clavicle angle, radiographic shoulder height, neck tilt, head shift) and distal compensatory curve showed significant improvement (P < 0.001). Postoperative C2-C7 angle increased, while thoracic kyphosis (TK) and lumbar lordosis (LL) decreased significantly. SRS-22 scores improved in "pain", "self-image", and "satisfaction with the management" domains. Five complications occurred, including fever, Pleural effusion, and distal curve progression.

CONCLUSION

One-stage posterior-only radical hemivertebra resection demonstrated efficacy in correcting both the cervicothoracic and compensatory thoracic curves, mitigating neurological complications, and enhancing patients' quality of life, thereby further substantiating its value in optimizing spinal alignment.

TRIAL REGISTRACTION: Registration was not applicable as this study retrospectively analyzed medical records generated during routine clinical practice.