Excision and Short Segment Fusion of a Double Ipsilateral Lumbar Hemivertebrae Associated With a Diastematomyelia and Fixed Pelvic Obliquity

Abstract

We report the surgical treatment course of a 4-year-old girl with congenital scoliosis, diastematomyelia and double adjacent hemivertebrae. She had a lumbar curve with an apparent pelvic obliquity. Simultaneous excision of double segmented sequential hemivertebra at the L3-L4 level and fusion with shortsegment instrumentation was performed via a posterior approach. Intraoperative radiographs revealed satisfactory curve correction and 0 degrees pelvic obliquity. Following the excision of double adjacent hemi-vertebrae, three adjacent nerve roots were placed in one intervertebral foramen bilaterally. Nevertheless, no neurological deficit was developed, and the patient was able to ambulate with a brace at day one. Pelvic balance and deformity correction were maintained with no implant failure at the fifth year followup. Excision of two ipsilateral adjacent hemivertebra and short-segment posterior fusion performed via posterior-only approach simultaneously is an effective, safe, and less invasive technique for the treatment of the described case. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.