Surgical Results in Hemivertebra-Induced Congenital Scoliosis: Long-Term Outcomes after a Minimum 5-Year Follow-Up
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Congenital scoliosis caused by hemivertebrae is one of the most challenging deformities in pediatric spinal surgery. This study aims to evaluate the long-term surgical outcomes in patients with hemivertebra-induced congenital scoliosis, compare the effects of different deformity types and surgical techniques on the radiological and clinical results, and determine the sustainability of the achieved correction. Materials and Methods: Between 2009 and 2019, 38 patients operated on by a single surgeon were retrospectively reviewed. The patients were classified according to the deformity type—isolated hemivertebrae (H1) and complex deformities (H2)—and according to the surgical technique—instrumentation and fusion alone (Group C) versus hemivertebra resection with short-segment fusion (Group R). Segmental coronal Cobb angle, compensatory curves, kyphotic angle, and coronal balance parameters were measured preoperatively, early postoperatively, and at the final follow-up. Intragroup and intergroup comparisons were performed, and a P value of <0.05 was considered statistically significant. Results: The mean preoperative segmental Cobb angle was 44°, which improved to 17° postoperatively, corresponding to a 64% correction maintained at the long-term follow-up ( P < 0.001). The correction rate was 66% in the resection group (Group R) and 59% in the correction-only group (Group C). No significant loss of correction was observed between early postoperative and final follow-up measurements in either group. However, at the last follow-up, the segmental coronal angle was significantly lower in Group R ( P = 0.018). The complication rates were comparable between the two groups. Conclusions: Posterior-based surgical strategies provide durable radiological correction in congenital scoliosis secondary to hemivertebrae when tailored to the deformity morphology and anatomical level. Hemivertebra resection with short-segment fusion provided improved local alignment at the final follow-up in selected thoracolumbar and lumbar cases, whereas correction-only instrumentation remained an effective option for more complex deformities. Complication rates should be interpreted in the context of long-term follow-up rather than the surgical technique alone, supporting an individualized, anatomy-driven surgical approach.
Source: Indian Spine Journal
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7212262548