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Three Rod Technique Facilitates Hemivertebra Wedge Excision in Young Children Through a Posterior Only Approach

Study Design. Retrospective case series. Objective. To study the efficacy of a 3-rod technique used in hemivertebra excision via a posterior only approach in young children to avoid implant failure. Summary of Background Data. Previous reports of posterior only hemivertebra excisions in young children have been associated with an unacceptable amount of implant failures and high revision rates. Methods. We reviewed our clinical experience in young children who underwent excision of a hemivertebra from a posterior only approach. All children had the wedge resection closed using a rod attached to laminar hooks and had the excision site stabilized with an additional 2 rods attached to pedicle screws. Results. In our series of 10 patients at an average age of 4 years and 3 months, all patients obtained fusion and there were no implant related complications or revisions needed. The average preoperative Cobb measurement of 44° was improved to 8° at most recent follow-up. Conclusion. The use of a 3-rod technique during hemivertebra excision in young children helped to avoid any implant failures in our series. We conclude that this technique should be used in young children whose pedicles may not be able to withstand the compressive forces needed to close down the wedge resection site.