Hemivertebral excision for congenital scoliosis in very young children

The present study reports the results of a consecutive series of six very y oung children who underwent single-anesthetic sequential anterior and poste rior hemivertebral excision. The children, all less than 34 months old (mea n age 19 months), presented with high magnitude or progressive congenital s coliosis related to an unbalanced hemivertebra. Curve correction required h emivertebral excision, which was accomplished during a single operative eve nt using sequential anterior and posterior procedures. The intraoperative c urve correction was maintained with plaster immobilization for 3 months. Al l patients were followed for at least 24 months. Pre- and postoperative spi nal radiographs were analyzed for initial and final curve correction. Excel lent correction of preoperative deformity was obtained and maintained throu ghout the follow-up period. The mean postoperative curve correction (67%; r ange 52%-84%) compared favorably with the average correction at final follo w-up (70%; range 50%-85%). Radiographs revealed a consistently solid arthro desis with no evidence of curve progression. There were no neurologic or ot her significant complications. In conclusion, single-anesthetic. sequential anterior and posterior hemivertebral excision appears to be a safe and eff icacious procedure for the management of congenital scoliosis in very young children.