Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Navigation
Abstract number: 26353
NAVIGATION-ASSISTED HEMIVERTEBRAE RESECTION AND PEDICLE SCREW
INSERTION IN TODDLES: 4 CASES PRELIMINARY STUDY
Chin-Wei CHEN, Chi-Kuang FENG, Chien-Lin LIU
Taipei Veterans General Hospital, Taipei (TAIWAN)
Introduction: Computerized image guidance has evolved as a scoliosis surgical tool.
Numerous laboratory and clinic studies have documented its precision of lumbar
pedicle screw insertion in idiopathic adolescent scoliosis. But, in toddle groups, no
adoption of navigation system in hemivertebrae resection and segmental pedicle
screw insertion was reported. Materials and Methods: We report four cases of
toddles (18-36 months) presenting de novo with fully segmented thoracolumbar
hemivertebrae in whom deformity merited surgical treatment. Posterior
hemivertebrae resection and pedicle screw insertion was performed using an image
navigation system (BrainLAB, Germany). Results: The average segment main curve
was 47° before surgery and 15° after surgery. Thus, the average main correction rate
was 72. In our cases, only monosegmental fusion of the two adjacent vertebrae was
performed. There were no neurologic complications in our cases. Excellent correction
rate and a short segment of fusion allows for normal growth in the unaffected parts of
the spine. Conclusion: Corrective surgery of congenital scoliosis with hemivertebra
should be performed early, before the development of severe deformities and
secondary structural changes. Posterior resection of the hemivertebrae with
transpedicular instrumentation allows for early intervention in very young children.
Due to poor visualization of anterior vertebrae, the long operation incision was
inevitable. The use of Computer Tomography navigation system successfully
reduced the operation incision, the perforation rate and insertion angle errors. It
demonstrates the clear advantage in safe and accurate pedicle screw placement in
corrective surgery of congenital scoliosis in small children.
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