Partial Hemivertebra Resection (Grade 4 Osteotomy) for Congenital Scoliosis: A Comparison with Radical Hemivertebra resection

To compare radiological and clinical outcomes between partial and radical hemivertebra (HV) resection in congenital scoliosis (CS) patients with single nonincarcerated HV. CS patients with single HV undergoing partial HV resection from February 2011 to May 2016 were retrospectively reviewed and included in the P group; those undergoing radical HV resection were included in the R group. Patients in R group were age-, sex-, curve magnitude-, and apex location-matched with those in P group. Comparisons were performed in terms of radiological results, clinical outcomes, and complications preoperation, postoperation, and at the last follow-up between the P and R groups. Both P and R groups included 25 CS patients, and the mean age at surgery was 10.1 ± 5.2 years. Compared with the R group, the P group had a similar correction of the Cobb angle at postoperation (38.6 ± 6.7° vs. 35.2 ± 5.6°, P = 0.057) and at the last follow-up (38.4 ± 7.0° vs. 34.7 ± 6.7°, P = 0.062). The estimated blood loss was 690.9 ± 291.3 mL in the R group and 502.2 ± 223.8 mL in the P group (P = 0.023), and the operating time was 259.4 ± 70.2 minutes in the R group and 206.9 ± 61.2 minutes in the P group (P = 0.007). During follow-up, no significant correction loss and major complication were observed in the P group, whereas 1 patient in the R group had rod breakage with pseudarthrosis at 24-month follow-up. Partial HV resection is a safe, effective, and less invasive procedure and achieved comparable correction with radical HV resection in the treatment of CS patients with single nonincarcerated HV.