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Posterior thoracolumbar hemivertebra resection and fusion with a biphasic calcium phosphate bone graft with a novel submicron surface topography
Abstract: Hemivertebra deformity and tethered cord syndrome are rather rare spinal anomalies and are not frequently reported in adults. The literature reports most cases occurring in children-with hemivertebra occurring in approximately 3-10 of 1000 births as a commonly recognized cause of congenital scoliosis in the thoracic and lumbar spine. Deformity related to the hemivertebra may progress quickly in the early years of life, or it may progress slowly into young adulthood. However, at some point, the negative effects on the spinal cord and the coronal and sagittal balance are likely to require surgical correction involving either anterior–posterior fusion or posterior resection with fusion. Surgeons face
many challenges in these surgical cases. One such challenge is having an adequate supply of autograft available for such complex, multi-segment procedures while avoiding additional procedures and increasing operative time. Identifying the most appropriate bone graft is important and the science behind the graft selected should be considered carefully. In recent years, the study of osteoimmunology has demonstrated the effects of the bidirectional interaction between bone cells and the immune system on bone development. In this report, we discuss the case of an adult female patient with a history of tethered cord release and known kyphoscoliosis presenting with a thoracolumbar hemivertebra at T12. The surgical treatment included a posterior resection and posterolateral fusion using this bone graft with a novel submicron surface topography and the radiological fusion findings observed in situ at 6 weeks post-surgery