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Fusi In Situ Posterior for Congenital Scoliosis with Wedge Hemivertebrae Using Single Rod and Pedicle Screw Instrumentation in Girl 2 Years Old: A Case Report

Pamudji Utomo, Adi Surya Dharma, Rieva Ermawan

Abstract

Background: Many spinal vertebral anoma­lies often occur, both scoliosis and kyfosis. In scoliosis, congenital abnormalities caused by hemivertebrae are the most common cause of abnormalities. The choice of treatment used can be either non-operative or operative. How­ever, non-operative treatment does not show satisfactory results to prevent the development of deformity. Operative treatment is an option that is considered to indicate more satisfying results. A variety of procedures such as in-situ posterior or with or without instrumentation anteroposterior fusions, combined anterior and poste­rior convex hemiepiphysiodesis and hemi­arthrodesis, and hemivertebral excision with fusion. Fusi In-situ posterior is a procedure option that is considered more beneficial for both surgeons and patients. This study aimed to evaluate the fusi in situ posterior for conge­nital scoliosis with wedge hemivertebrae using single rod and pedicle screw instrumentation in girl 2 year old.

Case Presentation: Girl 2 year old with wedge hemivertebrae operated with fusion in situ posterior using single rod and pedicle screw instrumentation.

Results: The operative treatment was per­formed on 2 hours operation time with amount of bleeding produced is 80 cc. There were no cranckshaft phenomena and no clinical and radological features suggestive of spinal ste­nosis. There were no major vascular or neuro­gical complications related to the pedicle screws. Then patient wore body jacket for limitation movement before fusion.

Conclusion: Posterior situ fusion is perform­ed as convex fusion to avoid curve progression. Fusion in situ posterior using single rod and pedicle screw instrumentation. In congenital scoliosis is minimal blood loss, less traumatic, simple, safe and effective procedure. This study showed the early fusi in situ posterior of conge­nital scoliosis structural changes occur above or below can reduce fusion length, prevent curve progression and effectively achieve a more satisfactory correction without hazardous iatro­genic spinal stenosis, crankshaft phenomena, or neurological complications. Further research is needed to assess the progress of the outcome of surgery

Keywords: congenital scoliosis, wedge hemi­vertebrae, convex, fusi in situ posterior

Correspondence: Pamudji Utomo. Department of Orthopaedic & Traumatology, Faculty of Medicine, Universitas Sebelas Maret/ Prof. Dr. R. Soeharso Ortho­pae­dic Hospital, Surakarta

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