![]() Posterior hemovertebral resection in pediatrics has been reported as the curative treatment of congenital scoliosis with successful results. Furthermore, there is some suggestion that the use of a posterior approach alone results in a better long-term correction compared with a combined anterior/posterior approach. For these congenital deformities, the early diagnosis and treatment by resection and short-level fusion appear to result in better deformity correction than when correction is performed at a later age. Compared with in situ bony fusion alone, the rate of correction was up to 61% after instrumented hemivertebra resection with simultaneous anterior and posterior fixation. In previous study, it was reported by Repko insufficient correction of the deformity if fusion was performed without resection of the hemivertebra, resulteing in a correction of the scoliosis of just 22.1%. The probability of progression depends on the type of hemivertebra and whether a combination of developmental failure in formation and segmentation is present. The form of a curve is usually more severe than the local malformation. ĭetermining the appropriate timing and type of surgery is important but difficult because natural evolution of a hemivertebra does not always lead to severe deformities and worsening of spinal deformities can occur during the pubertal growth spurt. It is usually difficult to correct by conservative treatment such as back brace, cast, and halotraction, which often requires surgery for correction in most cases with curve progression. With the exception of some incarcerated types, hemivertebrae have growth potential and create a wedge-shaped deformity that progresses during further spinal growth. Hemivertebrae, which are the most frequent cause of congenital scoliosis, pose a challenge in terms of prognosis and therapy. Congenital scoliosis is usually the result of failure of formation and/or segmentation.
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