57. Congenital scoliosis patients can attain similar curve correction and perioperative outcomes to AIS patients without the need for hemivertebra excision

BACKGROUND CONTEXT Hemivertebra excision in patients with congenital scoliosis is believed to give the best possible correction. It is, however, a technically challenging procedure and complications can include spinal cord injury, nerve root injury and CSF leak. We have utilized a hemivertebra-sparing approach in these patients alongside multi-level Ponte osteotomies and all pedicle screw constructs. PURPOSE To determine if this approach leads to similar perioperative correction and radiographic outcomes to AIS patients. STUDY DESIGN/SETTING A retrospective case-controlled matched study. PATIENT SAMPLE Twenty-four patients with congenital scoliosis and associated hemivertebra compared with the most recent 54 AIS correction surgeries with 2-year follow-up. OUTCOME MEASURES Curve correction, surgical time, blood loss, complications, length of stay, levels fused, fixation points. METHODS Twenty-four patients with congenital scoliosis and associated hemivertebra were included. These 24 patients were compared with the most recent 54 AIS correction surgeries with 2-year follow-up. An additional rigorous analysis was done to match hemivertebra patients from a database of 330 AIS patients. Patients were matched based on gender, age, BMI, and preop Cobb. Overall, 12 pairs (24 patients) were matched and analyzed. RESULTS When comparing hemivertebra to AIS patients, age (p=0.81), BMI (p=0.24) and preop Cobb (p=0.06) were similar. Postop Cobb (p=0.048) was significantly larger for AIS patients, however, overall Cobb correction was similar (p=0.29). Blood loss was similar (p=0.09) while surgical time (p CONCLUSIONS Patients with hemivertebra can benefit from hemivertebra sparing approach. The XR and periop outcomes were similar to AIS patients. This approach is safer compared to hemivertebra excision with similar or better curve correction than previously reported. Choosing fusion levels on similar principles akin to AIS leads to avoidance of hemivertebra excision in most cases including lumbosacral hemivertebra cases. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.