Congenital scoliosis of the spine

Congenital scoliosis is a deformity of the spine caused by improper formation of some of the vertebrae. He appears because of the influence of a pathological agent in the first six weeks of pregnancy. Congenital scoliosis is not inherited, it can be diagnosed at a very early age.

Types of congenital scoliosis

There are two main types of congenital scoliosis: scoliosis due to disruption of segmentation and pathology of formation. If the segmentation is broken, two or more vertebrae join together. At the point of their connection, growth slows, and on the other side, on the contrary, growth is more intense. This is how the deformation of the spine is formed. The most common form of scoliosis is disruption of the formation. It arises against the background of growth of vertebrae of irregular shape.

Diagnosis and examination

There are several signs that determine the degree of malignancy of congenital scoliosis. In the thoracic region, anomalies usually progress much more often than in the lumbar region. The presence of several altered vertebrae from one side is also a negative sign. Since the fastest growth was observed in children under five years old, as well as in adolescence, it is during these periods that the greatest attention should be paid to the child.

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If there is a suspicion of congenital scoliosis, it is necessary to make standard radiographs of the spine in two projections - lateral and direct. This will help to identify abnormal vertebrae and the degree of their deformation. To exclude pathology from the spinal cord, MRI can be recommended. Congenital scoliosis in 20% of cases develops along with anomalies in the genitourinary system and in 10% of cases - with abnormalities of the cardiovascular system.

Treatment

With a progressive deformation of up to 45 °, the doctor appoints a special corset. Flexible deformations are better suited to such treatment. The purpose of the corset is not to correct the deformation, but to completely stop its progression. A good result of treatment in the corset is when the deformations before treatment and after treatment are equal.

Halo-Traction

Halo-metal ring, which under general anesthesia is worn on the head and fixed with screws to the skull. Then, with the help of metal rods, the halo-ring connects with the pelvic bones. Metal rods extend with a small periodicity, stretching the deformed spine and gradually straightening it.

Gemi-epiphysiodez

Surgical procedure aimed at removing areas of excessive growth on the side of deformation. Any deformation has a convex and concave part. When the growth zones are removed and fixed using metal implants on the convex side, growth can occur on the concave side. Usually this leads to self-correction of deformation.

Surgical removal of the semi-vertebrae

For the procedure, apply front, rear and combined access. After removal of the altered vertebra, stabilization and forced fusion of the underlying and overlying vertebrae are needed. In the postoperative period, patients often need to wear a medical corset. This operation is quite effective, but has many risks, including acute neurologic complications and severe bleeding.

The growing designs of

The advantage of this operation is that, in parallel with the growth of the child's spine, the design is lengthened. The operation is performed from the rear access. With the help of hooks or transpedicular screws, one or two rods are attached to the child's spine. Once in 6-8 months they are lengthened. Usually the child is assigned in parallel and the corset. In our time, the development of new growing systems is underway, which does not require such frequent surgeon interventions. They are prolonged independently, along with the growth of the child.

Spondylode( merger)

This complex surgical procedure is aimed at stopping the growth of the spine in a certain segment. The surgeon removes the articular parts of the posterior vertebral element, and instead places bone grafts. Over time, they fuse with the vertebrae, forming a single bone block. Even in the process of growth, it does not change its form, that is, the deformation does not progress. This procedure has a serious disadvantage - complete unpredictability of bone behavior during active growth. There may be a progression of scoliosis in another part of the spine.