Posterior girişimle hemivertebrektomi: Olgu sunumu

Amaç: Hemivertebra nadir görülen ve skolyoza sebeb olabilen bir spinal anomalidir. Cerrahi tedavisinde tek başına posterior girişim ile hemivertebrektomi yeni, efektif ve konvansiyonel yöntemlere göre daha az invazifdir. Olgu sunumu: 20 aylık erkek bir çocukta lomber 2’de tam segmentleşmiş hemivertebra ve buna bağlı progresif skolyoz nedeniyle yalnız posterior girişim kullanılarak hemivertebrektomi yapıldı. Sonuç: Postoperatif dönemde hem sagittal ve hem de koronal planda tam korreksiyon sağlandı. On iki aylık takiplerinde ciddi korreksiyon kaybı saptanmadı. Posterior girişimle hemivertebrektomi; konvansiyonel hemivertebra cerrahisine gore minimal invazif bir girişim olup, deformitenin 3 boyutlu korreksiyonunda oldukça etkili bir yöntemdir.

Hemivertebrectomy via posterior approach alone: A case report

Objective: Hemivertebra is a rare spinal anomaly that lead to scoliosis. Posterior approach is an innovative and effective method in the surgical treatment of hemivertebra without combined with anterior approach. Case report: 20 months old boy with fully segmented hemivertebra at the second lumbar vertebra causing progressive scoliosis underwent to a posterior hemivertebrectomy approach. Conclusion: Postoperatively complete correction was obtained in both coronal and sagittal plan. No severe correction loss had seen at follow-up of 12 months. Posterior approach when compared with conventional methods for hemivertebrectomy is a minimally invasive and a very effective method to obtain three dimentional correction of the deformity.

___

  • 1. Leatherman KD. The management of rigid spinal curves. Clin Orthop 1993;93:215-24. 2. Holte DC, Winter RB, Lonstein JE, Denis F. Excision of hemivertebrae and wedge resection in the treatment of congenital scoliosis. J Bone Joint Surg 1995;77(A):159-71. 3. Wiles P. Resection of dorsal vertebrae in congenital scoliosis. J Bone Joint Surg 1951;33A;151-3. 4. Slot GH. The importance of vertebral resection in correction of spinal deformities such as scoliosis, kyphosis and hyperlordosis in the thoracic and in the lumbar region: A Orthopaedic Association. J Bone Joint Surg 1981;63(B):286. 5. Leatherman KD, Dickson RA. Two-stage corrective surgery for congenital deformities of the spine. J Bone Joint Surg 1979;61(B):324-8. 6. McCarthy RE. One-stage lumbar hemivertebra excision in infants. Clin Orthop 1973;93:215-24. 7. Lazar RD, Hall JE. Simultaneous anterior and posterior hemivertebra excision. Clin Orthop Rel Res 1999;364:7-84. 8. Bradford DS, Boachie-Adjei O. One-stage anterior and posterior hemivertebra resection and arthrodesis for congenital scoliosis. J Bone Joint Surg 1990;72(A):536-40. 9. Shono Y, Abumi K, Kaneda K. One-stage posterior hemivertebra resection and correction using segmental posterior instrumentation. Spine 2001;26:752-7. 10. Ruf M, Harms J. Hemivertebra resection by a posterior approach. Spine 2002;27:1116-23.