Resection and corrective spondylodesis of the hemivertebra
What is it?
A hemivertebra is a congenital spinal anomaly where a vertebra develops incompletely or is wedge-shaped, leading to an abnormal spine curvature. This condition can result in progressive spinal deformities such as scoliosis (sideways curvature) or kyphosis (forward curvature). The decision to proceed with surgery considers the severity of the deformity, the patient’s age, and the potential for progression. Correcting the spinal deformity can alleviate pain and discomfort associated with the condition, improving the overall quality of life and functionality.
Recovery involves a hospital stay and a period of rehabilitation, which may include physical therapy to strengthen the back muscles and improve flexibility. In younger patients, ongoing monitoring of spinal growth and development is crucial to ensure the long-term success of the surgery.
Procedure
Resection of the Hemivertebra: The first part of the procedure involves the surgical removal (resection) of the hemivertebra. This step is crucial as it directly eliminates the structural cause of the spinal deformity. The approach to the hemivertebra can be from the back (posterior), front (anterior), or a combination of both, depending on its location and the extent of the deformity. A posterior approach is more common. The surgeon accesses the spine, isolates the malformed vertebra, and carefully removes it, taking care not to harm the surrounding spinal nerves and structures.
Corrective Spondylodesis: Following the resection, the procedure involves corrective spondylodesis – a form of spinal fusion. This step aims to stabilize the spine and correct the abnormal curvature. The adjacent vertebrae are fused using bone grafts, and often, metallic hardware like rods and screws are used to maintain proper spinal alignment and ensure stability during the healing and fusion process.
By removing the hemivertebra, the procedure effectively corrects or significantly reduces the abnormal curvature of the spine, leading to an improved posture and spinal alignment. Resection and spondylodesis prevent further spinal deformity progression, which is crucial in growing children and adolescents.