Computer-assisted hemivertebral resection for congenital spinal deformity
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概要
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No studies have reported on osteotomies utilizing a navigation system in congenital scoliosis surgery. This study aimed to evaluate the surgical outcomes of eight patients with congenital scoliosis or kyphoscoliosis due to hemivertebrae treated by computer-assisted hemivertebral resection using only a posterior approach. Eight consecutive patients (two scoliotics and six kyphoscoliotics) managed by computer-assisted hemivertebral resection using only a posterior approach with transpedicular instrumentation were investigated retrospectively. A CT-based navigation system was used to confirm the positions of the vertebra, spinal cord and aorta in real-time when we inserted a pedicle screw and conducted the osteotomy. The mean patient age at surgery was 18 years (range 11-41 years). The mean follow-up was 46 months (range 18-84 months). Before surgery, the mean kyphotic curve was 55.8A degrees (range 26-83A degrees), and the mean scoliotic curve was 50.0A degrees (range 36-62A degrees). At the final follow-up period, the curves averaged 23.2A degrees (range 15-40A degrees) and 31.6A degrees (range 21-44A degrees), respectively, yielding kyphotic angle corrections of 32.7A degrees (range 11-58A degrees) and Cobb angle correction rates of 36.8% (range 24.1-48.3%). A total of 72 pedicle screws were inserted with the navigation system, and two screws revealed a perforating pedicle. No neurovascular complications occurred. The perforation rate was 2.8%. Hemivertebral resection via a single posterior approach is less invasive than combined anterior and posterior approaches; however, this procedure increases the risk of spinal cord and vascular injuries. Computer-assisted hemivertebral resection enables safe and accurate performance of a hemivertebral resection via a single posterior approach.
- SPRINGER TOKYOの論文
SPRINGER TOKYO | 論文
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