One-stage posterior hemivertebra resection combined with short-segment fusion for congenital scoliosis: a mid-to-short-term follow-up of over two years

Congenital scoliosis is one of the most common spinal deformities, often leading to underdevelopment of cardiopulmonary function in children, and may even result in severe cardiopulmonary damage, including respiratory failure and cor pulmonale. Most hemivertebral deformity scoliosis progresses rapidly, and conservative treatment is generally ineffective, ultimately requiring surgical intervention. This study evaluates the surgical outcomes of posterior hemivertebrectomy combined with short-segment fusion and pedicle screw fixation for congenital scoliosis, with a mean follow-up of 2.5 years. This is a retrospective study that included 24 patients with hemivertebral scoliosis who underwent posterior hemivertebrectomy combined with short-segment fusion between 2017 and 2023, with an average follow-up period of 2.5 years (ranging from 1.4 to 5 years). Surgical records and radiological assessments were reviewed. Surgical records included operation time, blood loss, transfusion volume, and postoperative complications. Radiological evaluations included segmental scoliosis, compensatory scoliosis, segmental kyphosis, coronal plane trunk balance, and measurement of pedicle screw placement accuracy. Among the 24 patients, 15 were male and 9 were female, with an average age of 5.4 years (ranging from 2.8 to 11.7 years), and an average follow-up of 29.4 months (ranging from 19 to 60 months). The preoperative mean segmental scoliosis was 37.92°, which was corrected to 10.79° postoperatively (correction rate 73.22%), and was 12.42° at the last follow-up (correction rate 68.52%) (P < 0.001). Postoperative compensatory scoliosis automatically corrected from 16° preoperatively to 5.79°, and was 7.54° at the last follow-up (P < 0.001). Coronal plane trunk deviation was corrected from 25.17 mm preoperatively to 11.17 mm, and remained stable during follow-up, measuring 11.99 mm at the last follow-up (P < 0.001). In the sagittal plane, segmental kyphosis was corrected from 24.04° preoperatively to 10.04° postoperatively (correction rate 53.53%), and was 12.42° at the last follow-up (correction rate 40.1%). From preoperative to last follow-up, segmental scoliosis, compensatory scoliosis, coronal plane trunk deviation, and segmental kyphosis showed significant correction (p < 0.001). However, there was no significant difference between postoperative and last follow-up assessments (P > 0.05). Two patients experienced transient neurological injury after surgery. Posterior hemivertebrectomy combined with short-segment fusion demonstrates good efficacy in the treatment of congenital scoliosis, effectively correcting spinal deformities with a low incidence of postoperative complications. Excellent correction was maintained during mid- to short-term follow-up.