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| Aqib Rasool,YANG Xi,ZHOU Chunguang.Clinical efficacy of posterior hemivertebra resection and cage implantation on the concave side in treating congenital lumbosacral hemivertebra deformity[J].Chinese Journal of Spine and Spinal Cord,2026,(4):442-450. |
| Clinical efficacy of posterior hemivertebra resection and cage implantation on the concave side in treating congenital lumbosacral hemivertebra deformity |
| Received:November 24, 2025 Revised:March 08, 2026 |
| English Keywords:Scoliosis Lumbosacral region Hemivertebra deformity Cage |
| Fund:四川省自然科学基金面上项目（2025ZNSFSC0272） |
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| English Abstract: |
| 【Abstract】 Objectives: To explore the clinical and radiological effects of cage implantation on the concave side after hemivertebra resection for the treatment of congenital lumbosacral hemivertebra deformity. Methods: The clinical data of 42 patients with congenital lumbosacral hemivertebra deformity who underwent surgical treatment at our hospital between January 2021 and December 2019 were analyzed retrospectively. Among the patients, 16 received posterior hemivertebra resection and cage implantation on the concave side were included into the cage group(4 males, 12 females, aged 16.82±6.54 years) and 16 patients(7 males and 9 females, aged 14.13±5.71 years) matched 1∶1 with the cage group after correcting for confounding factors by propensity score matching method from the left 26 patients who received single posterior hemivertebrectomy were included into a non-cage group. The operative time, blood loss, implant failure were compared between groups, as well as imaging parameters[Risser sign, lumbosacral scoliosis angle, thoracolumbar/lumbar scoliosis Cobb angle, coronal balance, pelvic tilt, pelvic incidence, sacral inclination, lumbar lordosis, lower lumbar lordosis, sagittal vertical axis] before, after operation, and at final follow-up. The Scoliosis Research Society-22(SRS-22) questionnaire scale was used to evaluate the health-related quality of Life(HRQoL) of the patients before operation and at final follow-up. Results: Both groups of patients successfully completed the operation. No statistically significant differences were observed between the two groups in operative time(174.20±73.53min vs 201.62±93.84min) or intraoperative blood loss(325.76±92.26mL vs 374.63±123.79mL)(P>0.05). There was no statistical significance between the two groups in the Risser sign, lumbosacral scoliosis, thoracolumbar/lumbar scoliosis, coronal balance, pelvic tilt, pelvic incidence, sacral inclination, lumbar lordosis, or sagittal vertical axis before operation(P>0.05). At final follow-up, the degrees of lumbosacral scoliosis and thoracolumbar/lumbar scoliosis in both groups were significantly improved compared with those before surgery(P<0.001). The cage group had better correction effect of lumbosacral scoliosis, with a significantly lower degree of scoliosis at the final follow-up than the non-cage group; The correction rates of lumbosacral scoliosis and thoracolumbar/lumbar scoliosis in the cage group were significantly higher than those in the non-cage group(P<0.05). In terms of sagittal balance, the lower lumbar lordosis angle in both groups was significantly improved at the final follow-up compared with that before surgery(P<0.05). The lower lumbar lordosis angle and its correction amplitude in the cage group were significantly better than those in the non-cage group(P<0.05), and no internal fixation failure in the cage group. Conclusions: For patients with congenital lumbosacral hemivertebra deformity, posterior column reconstruction by implanting an cage on the concave side based on posterior hemivertebra resection can significantly improve the coronal correction rate of lumbosacral deformity and lumbar lordosis angle, which is more conducive to restoring the coronal and sagittal balance of the spine. |
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