Congenital Scoliosis

Congenital scoliosis is a type of scoliosis that is present at birth. Unlike other forms of scoliosis that may develop later in life, congenital scoliosis results from abnormal vertebral development during the early stages of fetal development. This condition occurs when the vertebrae do not form properly, leading to a curvature of the spine. The abnormal development can affect the shape, size, or segmentation of the vertebrae.

Congenital scoliosis treatment leads to rock-solid success - Kai Weir

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Key points about congenital scoliosis include:

  • Causes:
    • Vertebral Malformation: The vertebrae may not form normally, leading to asymmetry and curvature of the spine.
    • Hemivertebrae: Incomplete development of one side of a vertebra, causing the spine to curve.
    • Wedge-shaped Vertebrae: Some vertebrae may be shaped like wedges, contributing to the curvature.
    • Unsegmented or Partially Segmented Vertebrae: Abnormal fusion or segmentation of vertebrae can affect spinal alignment.
  • Diagnosis:
    • Often identified during infancy or early childhood through physical examination and imaging studies such as X-rays or MRI.
    • Genetic testing may be considered in some cases.
  • Severity and Progression:
    • The severity of congenital scoliosis varies widely. Some cases may have minimal impact, while others can be more severe.
    • Progression may occur as the child grows, and close monitoring is often necessary.
  • Associated Conditions:
    • Congenital scoliosis may be associated with other congenital anomalies affecting the heart, kidneys, or other organs.
    • Early evaluation by a pediatrician and relevant specialists is essential to assess for associated conditions.
  • Treatment:
    • Management depends on the severity of the curvature and associated health issues.
    • Observation: Mild cases may only require periodic monitoring to assess progression.
    • Bracing: In some cases, especially if the curvature is progressive, bracing may be recommended to help control spinal alignment.
    • Surgery: Severe cases or those with associated health concerns may require surgical intervention to correct the curvature and provide spinal stability.

Treatment decisions are made on a case-by-case basis, considering the specific characteristics of the congenital scoliosis and the overall health of the individual. Regular follow-up with healthcare professionals, including orthopedic specialists, is crucial to monitor the condition and determine the most appropriate course of action.

Surgical options for congenital scoliosis are considered when the curvature of the spine is severe, progressive, or associated with other health issues. The goal of surgery is to correct the spinal deformity, prevent further progression, and maintain a stable and balanced spine. The specific surgical approach depends on the characteristics of the congenital scoliosis and the individual’s overall health. Here are some common surgical options:

  • Spinal Fusion:
    • Spinal fusion is a common surgical procedure for congenital scoliosis.
    • It involves the use of bone grafts and sometimes instrumentation (such as rods, screws, or wires) to fuse the affected vertebrae together, stabilizing the spine.
    • The bone grafts stimulate the growth of new bone, essentially eliminating motion at the fused segment.
  • Hemivertebrae Resection:
    • In cases where a hemivertebra (a wedge-shaped vertebra) contributes significantly to the curvature, surgical removal of the hemivertebra may be considered.
    • This procedure helps to correct the spinal deformity and achieve better alignment.
  • Dr. Borden and Kai Weir together holding 3D SpineGrowing Rods or Vertical Expandable Prosthetic Titanium Rib (VEPTR):
    • In pediatric cases with congenital scoliosis, especially when the child is still growing, growing rods or VEPTR devices may be implanted.
    • These devices are adjustable and are periodically lengthened to accommodate the child’s growth, helping to control the progression of the curvature.
  • Tethering:
    • Tethering is a newer surgical technique that involves placing a flexible cord or material along the concave side of the spine to partially restrict its growth.
    • This allows for controlled growth on the convex side, helping to correct the curvature over time.
  • Vertebral Column Resection:
    • In severe cases where the spinal deformity is complex, vertebral column resection may be performed.
    • This involves removing a portion of the vertebra or multiple vertebrae to allow for correction and stabilization of the spine.

The choice of surgical technique depends on factors such as the age of the patient, the severity and location of the curvature, and the overall health of the individual. The decision to undergo surgery and the specific approach taken are typically made collaboratively between the patient, their family, and a team of healthcare professionals, including orthopedic surgeons and spine specialists. Regular follow-up care and monitoring are important after surgery to assess the success of the procedure and address any ongoing concerns.