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Case report
Selective hemivertebrae resection in congenital scoliosis with multiple hemivertebrae
  1. Bhavuk Garg and
  2. Nishank Mehta
  1. Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Nishank Mehta; mehta.nishank{at}gmail.com

Abstract

There are no established guidelines regarding the surgical strategy to be adopted in congenital scoliosis with multiple hemivertebrae—decision has to be guided taking into account the contribution of each hemivertebra to the deformity and its growth potential. We describe a case of a 12-year-old woman with congenital scoliosis due to unbalanced multiple hemivertebrae. Preoperative imaging revealed the presence of three hemivertebrae—at D7, D10 and L5. Our surgical strategy was guided by various factors—the morphology of the hemivertebrae, the location, the contribution of each hemivertebra to the deformity and their relationship to each other. Based on this, we performed a selective hemivertebrae resection—completely resecting L5 hemivertebra and performing ‘egg-shell’ decancellation of D7 hemivertebra and in situ fusion of D10 hemivertebra, yielding satisfactory results. This case report illustrates a rational thought process that can guide a paediatric spinal deformity surgeon in treating scoliosis with multiple hemivertebrae.

  • orthopaedic and trauma surgery
  • neurosurgery
  • orthopaedics
  • musculoskeletal and joint disorders

https://doi.org/10.1136/bcr-2020-240355

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    Footnotes

    • Contributors BG was involved in conception and design; provided intellectual content; helped with data analysis and interpretation, manuscript editing and review, and approval of the final manuscript; and agree to be accountable for all aspects of work. NM was involved in conception and design; provided intellectual content; helped with data acquisition, data analysis and interpretation, manuscript editing and review, and approval of the final manuscript; and agree to be accountable for all aspects of work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.