Congenital Scoliosis' Overview and Hemivertebra Excision

Abstract

Congenital failure of formation, segmentation of the spinal column or a combination of them may give rise to spinal deformities. The prognosis depends on the growth differential between the two sides of the spine. Treatment of this condition has to be individualized based on the anatomical derangement. With improvements in surgical techniques, implants and perioperative management, hemivertebra excision has been increasing in popularity. For those that are indicated, this procedure has the advantage of immediate deformity correction, spinal motion preservation by short segment fixation, and prevention of progression. The techniques available include a combined anterior and posterior approach, for those with large anterior components, and posterior only, particularly useful for the quadrant vertebra. With the use of pedicle screws, which allow anterior column control from posterior, the posterior only approach is favored. This talk will discuss the indications and techniques for both these approaches.