후방 도달 반척추 절제술로 치료한 선천성 척추 측만증 (Posterior Hemivertebra Excision in Congenital Scoliosis)

서지정보

· 발행기관 : 대한척추외과학회
· 수록지 정보 : 대한척추외과학회지 / 15권 / 1호 / 1 ~ 8페이지
· 저자명 : 안종국, 김진혁, 김성수, 조범철, 정락용, 석세일

초록

Study Design: Retrospective study
Objectives: To evaluate the surgical outcome of congenital scoliosis with a hemivertebra treated by posterior hemivertebra excision
and pedicle screw instrumentation.
Summary of Literature Review: Posterior hemivertebra excision can be accomplished through a single posterior approach, and
excellent correction and outcome may be achieved.
Materials and Methods: Forty patients with one fully segmented hemivertebra treated by posterior hemivertebra excision with
pedicle screw instrumentation were retrospectively analyzed after a minimum follow-up of 2 years (range 2~7.7 years). The
mean age at surgery was 15.9 years (range 2.6~37.9 years). Preoperative and postoperative standing radiographs were used to
assess radiographic parameters.
Results: The average number of vertebrae in the major curve was 4.2 (range 3~8), and the average flexibility was 29% (range
8~59%). The average length of fusion was 3.5 segments (range 1~6). The number of fused vertebrae had a positive correlation
with age at the index surgery (r=0.345, p 0.05). Mean preoperative scoliosis of 48±12。was corrected to a mean of 17±10。
(65% correction), and mean preoperative kyphosis of 46±18。was corrected to a mean of 12±12。at the most recent follow-up.
The compensatory curve had a mean of 25±10。preoperatively and spontaneously corrected to a mean of 8±8。(70% correction)
at the most recent follow-up. The mean operating time was 233±81 min, with an average blood loss of 2904 ml. There
was neither crankshaft phenomenon nor iatrogenic spinal stenosis in 6 patients under the age of 5 years after an average follow-
up of 6 years.
Conclusions: Posterior hemivertebra excision using pedicle screw instrumentation in congenital scoliosis due to a hemivertebra
is a safe and effective procedure. Posterior hemivertebra excision at an early age may reduce the fusion length while avoiding
the induction of iatrogenic spinal stenosis during follow-up.

영어초록

Study Design: Retrospective study
Objectives: To evaluate the surgical outcome of congenital scoliosis with a hemivertebra treated by posterior hemivertebra excision
and pedicle screw instrumentation.
Summary of Literature Review: Posterior hemivertebra excision can be accomplished through a single posterior approach, and
excellent correction and outcome may be achieved.
Materials and Methods: Forty patients with one fully segmented hemivertebra treated by posterior hemivertebra excision with
pedicle screw instrumentation were retrospectively analyzed after a minimum follow-up of 2 years (range 2~7.7 years). The
mean age at surgery was 15.9 years (range 2.6~37.9 years). Preoperative and postoperative standing radiographs were used to
assess radiographic parameters.
Results: The average number of vertebrae in the major curve was 4.2 (range 3~8), and the average flexibility was 29% (range
8~59%). The average length of fusion was 3.5 segments (range 1~6). The number of fused vertebrae had a positive correlation
with age at the index surgery (r=0.345, p 0.05). Mean preoperative scoliosis of 48±12。was corrected to a mean of 17±10。
(65% correction), and mean preoperative kyphosis of 46±18。was corrected to a mean of 12±12。at the most recent follow-up.
The compensatory curve had a mean of 25±10。preoperatively and spontaneously corrected to a mean of 8±8。(70% correction)
at the most recent follow-up. The mean operating time was 233±81 min, with an average blood loss of 2904 ml. There
was neither crankshaft phenomenon nor iatrogenic spinal stenosis in 6 patients under the age of 5 years after an average follow-
up of 6 years.
Conclusions: Posterior hemivertebra excision using pedicle screw instrumentation in congenital scoliosis due to a hemivertebra
is a safe and effective procedure. Posterior hemivertebra excision at an early age may reduce the fusion length while avoiding
the induction of iatrogenic spinal stenosis during follow-up.

참고자료

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