• Harish S Hosalkar, Lael M Luedtke, and Denis S Drummond.
• Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
• Spine. 2004 Nov 15;29(22):2581-7.

Study DesignThe authors conducted a retrospective study involving description of a new surgical technique.ObjectivesThe objective of this study was to describe and evaluate the efficacy of a new technique to stabilize the spine of young and small patients with congenital scoliosis after lumbosacral hemivertebra excision.Summary Of Background DataCongenital scoliosis develops as the result of anomalous vertebral development and asymmetric growth. The vertebral anomalies include congenital fusions and congenital hemivertebrae. With lumbosacral hemivertebrae at the lumbosacral junction, surgical excision followed by instrumentation to close the resulting space is frequently the best way to correct the deformity and obtain spinal balance. Surgical stabilization is required for preventing recurrent deformity and restoration of spinal balance.MethodsA new surgical technique for spinal correction and stabilization in congenital scoliosis is described. The technique involves hemivertebra excision followed by fixation of the adjacent normal vertebra to the ilium with screws and cables. This technique allows efficient correction in both the coronal and sagittal planes.ResultsThis construct was prospectively studied in 3 cases over a 3- to 5(1/2)-year period. All cases had solid fusion and well-balanced spine at latest follow up.ConclusionsThis prospective study demonstrates a successful surgical technique for spinal stabilization after congenital hemivertebra excision in infants and young children with relatively small and soft bones when standard constructs like pedicle screws may not be optimal devices. Coronal and sagittal balance (restoration with improvement of lordosis) was successfully achieved in all cases.

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