Hemivertebral excision for congenital scoliosis in very young children

The present study reports the results of a consecutive series of six very young children who underwent single-anesthetic sequential anterior and posterior hemivertebral excision. The children, all less than 34 months old (mean age 19 months), presented with high magnitude or progressive congenital scoliosis related to an unbalanced hemivertebra. Curve correction required hemivertebral excision, which was accomplished during a single operative event using sequential anterior and posterior procedures. The intraoperative curve correction was maintained with plaster immobilization for 3 months. All patients were followed for at least 24 months. Pre- and postoperative spinal radiographs were analyzed for initial and final curve correction. Excellent correction of preoperative deformity was obtained and maintained throughout the follow-up period. The mean postoperative curve correction (67%; range 52%-84%) compared favorably with the average correction at final follow-up (70%; range 50%-85%). Radiographs revealed a consistently solid arthrodesis with no evidence of curve progression. There were no neurologic or other significant complications. In conclusion, single-anesthetic sequential anterior and posterior hemivertebral excision appears to be a safe and efficacious procedure for the management of congenital scoliosis in very young children.