Reconstructive surgery for the post-hemiepiphysiodesis residual deformity in congenital scoliosis

Eur J Orthop Surg Traumatol. 2013 Jul:23 Suppl 1:S111-3. doi: 10.1007/s00590-013-1183-4. Epub 2013 Feb 9.

Abstract

Spinal hemiepiphysiodesis is a well-known surgical procedure for correcting angular deformity in which the anterior and/or posterior epiphyseal plates of several vertebrae are fused on the convex side of the curvature with the expectation of spontaneous correction through continued growth of the concave side. We report on a patient with congenital scoliosis that had problems after hemiepiphysiodesis and required a salvage, reconstructive, antero-posterior combined surgery with instrumentation and osteotomy. After hemiepiphysiodesis, a marked fusion mass and a loss of bony landmarks made osteotomy and correction with a salvage surgery extremely difficult. We suggest that confirming the fusion area after hemiepiphysiodesis and determining the appropriate osteotomy site by 3D reconstruction images are important before salvage operations.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Blood Loss, Surgical
  • Child
  • Disease Progression
  • Female
  • Humans
  • Laminectomy / methods*
  • Neurologic Examination
  • Operative Time
  • Reoperation / methods
  • Scoliosis* / congenital
  • Scoliosis* / diagnosis
  • Scoliosis* / physiopathology
  • Scoliosis* / surgery
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / methods
  • Thoracic Vertebrae* / abnormalities
  • Thoracic Vertebrae* / diagnostic imaging
  • Thoracic Vertebrae* / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome