Purpose: The purpose of this work was to present the long-term outcome after resection of thoraco-lumbar, lumbar, or lumbosacral hemivertebrae in 69 children.

Material and methods: Sixty-nine children (35 girls and 34 boys) underwent surgery at a mean age of 3 years (range 1 year – 10 years 6 months). Mean follow-up was 6 years (range 6 months – 18 years). Resections involved thoracolumbar (n=20), lumbar (n=34), and lumbosacral (n=15) hemivertebrae. Congenital vertebral and visceral malformations were present in 32% and 41% of the children respectively. Ten patients had an underlying neurological malformation.

A single operation was performed in 60 patients using a combined anterior and posterior approach and convex posterior CD baby instrumentation. Nine patients underwent two operations one week apart. All patients wore a corset brace for six months.

Results: Structure curvature: the mean Cobb angle was 35° preoperatively, 16° postoperatively, and 15° at last follow-up.

Compensating curvature: the mean Cobbe angle was 21° preoperatively and 12° at last follow-up. Complications: partial deficit of the anterior tibialis (n=1), nonunion (n=3), infection (n=1), disassembly (n=3), valgum tibia at the site of the fibular graft harvesting (n=1).

Discussion: At these spinal levels, hemivertebral resection appears to be the most appropriate technique for children aged less than three years as long as there are no clear signs of progressive curvature.