Treatment of congenital scoliosis with single-level hemivertebrae.
The natural history of congenital scoliosis with hemivertebrae is unpredictable and the management is also controversial. Between 1986 and 2004, 22 patients (eight male and fourteen female, mean 19.3 years old) with single-level hemivertebrae related congenital scoliosis underwent non-operative or operative treatment at our institution with an average follow-up period of 8.8 years. Only a 5 degrees curve progression was noted in upper thoracic hemivertebrae after followed up 6 years. By one stage combined anterior hemivertebrae excision, posterior instrumentation, and arthrodesis, up to 61% curve correction can be achieved. Posterior instrumentation, correction and arthrodesis showed a 25% correction. The result of pain relief is promising in skeletal-matured patients. Surgical instrumentation, correction and arthrodesis showed good results. The optimal treatment of choice may differed from one to the other.