Int Orthop. 2025 Jul 5. doi: 10.1007/s00264-025-06595-0. Online ahead of print.
ABSTRACT
PURPOSE: This study compares short-segment (2-level) versus longer-segment (> 2-level) fusion after posterior hemivertebra resection in congenital scoliosis (CS) and identifies preoperative thresholds to guide fusion strategy selection.
METHODS: Eighty-eight CS patients (mean age: 5.42 years) undergoing hemivertebra resection with fusion (31 short-segment [Fused_2], 57 longer-segment [Fused_GT2]) were retrospectively analyzed. Radiographic parameters, complications, and reoperations were assessed. Logistic regression derived predictive thresholds for fusion length.
RESULTS: Both groups achieved comparable initial (~ 77%) and final (~ 61%) main curve correction. The Fused_2 group had shorter operative time (154 vs. 204 min, p < 0.001) and lower blood loss (249 vs. 356 mL, p = 0.011). Reoperation rates (20.5% overall), crankshaft phenomenon (25.0%), and neurological complications (5.7%) did not differ between groups. Preoperative main curve ≤ 41.8° and thoracic kyphosis ≤ 30.2° predicted suitability for 2-segment fusion.
CONCLUSION: Short-segment fusion reduces invasiveness without compromising correction in select CS patients. Preoperative thresholds (main curve ≤ 41.8°, kyphosis ≤ 30.2°) may guide strategy, though individualized assessment remains essential.
PMID:40616658 | DOI:10.1007/s00264-025-06595-0
