Similar Results Obtained in Two Hemivertebrectomy Approaches
More minor complications associated with posterolaterally operated patients
MONDAY, Jan. 17 (HealthDay News) -- Posterolateral (PL) hemivertebra excision for congenital scoliosis is comparable to the more predominant anteroposterior (AP) approach in terms of clinical, radiographic, and quality of life outcomes, according to a study published in the Jan. 1 issue of Spine.
Tuomas Jalanko, B.M., of the Helsinki University Hospital for Children and Adolescents in Finland, and colleagues compared results in 12 AP and 11 PL hemivertebra resections conducted between 2001 and 2008 for congenital scoliosis or kyphoscoliosis. The researchers compared the mean Cobb angle of the main curve before and after surgery, the Scoliosis Research Society (SRS)-24 scores, and the complication rates in the two groups. Average age at surgery was 4.0 years and mean follow-up time was 2.5 years.
The researchers found the main curve had been corrected to a mean of 12 degrees for the AP group and 15 degrees for the PL group at the final follow-up visit, which was not statistically different. The SRS-24 total scores were similar at follow-up; although, PL operated patients had better scores immediately after surgery. Average hospitalization time and days spent in intensive care were also similar in the two groups. The complication rate in the AP group was 8 percent; whereas, the PL group had a complication rate of 40 percent (P = 0.14). No implant failures were observed, nor was there any serious or permanent neurologic complication in either group.
"PL resection is technically more demanding and [a] slightly faster method for hemivertebral resection. It has nearly as good correction rate as the AP-method but more minor complications," the authors write.
The authors disclosed that the study was funded in part with support from medical device companies.