SURGICAL TREATMENT OF CHILDRENWITH CONGENITAL DEFORMITYOF THE UPPER THORACIC SPINE

Abstract

Objective. To assess the results of surgical treatment of children with congenital deformities of the upper thoracic localization associated with vertebra formation failure.

Material and Methods. Eighteen patients aged one year and four months to nine years with isolated congenital malformations in the upper thoracic spine were operated on. Six patients had lateral hemivertebrae, and 12 patients – posterolateral hemivertebrae. All patients underwent posterior surgical approach for extirpation of hemivertebra and adjacent discs, deformity correction with posterior instrumentation, corporodesis, and posterior local fusion with bone autograft.

Results. Scoliosis angle after surgical treatment ranged from 0° to 6°, and correction degree – from 86% to 100%. After extirpation of posterolateral hemivertebra the mean angle of residual scoliotic component was 2.5°, and that of the kyphotic component – 8.2°, the degree of correction ranged from 62% to 80%. Formation of solid fusion was observed in all patients within 1.5–2 years after surgery. There were no early or late postoperative complications and neurological disorders.

Conclusion. Posterior surgery for congenital malformation in the upper thoracic spine associated with vertebra formation disorders provides radical correction of the existing deformity with minimum number of fixed spinal motion segments, prevents deformity development and progression in the dysplastic type, and does not hamper a further growth of the spine as a whole.