SURGICAL TREATMENT OF CHILDREN WITH CONGENITAL THORACIC SPINE DEFORMITY ASSOCIATED WITH VERTEBRAL MALFORMATION

Objective. To evaluate the results of surgical treatment in children with congenital deformity of the thoracic spine associated with isolated vertebral anomalies.

Material and Methods. A total of 50 patients aged 1 year 4 months to 7 years 8 months with isolated congenital lateral hemivertebra or posterolateral hemivertebra in the thoracic spine were operated on. Surgical intervention through combined anterolateral and posterior approach included extirpation of the abnormal vertebra with adjacent discs, correction of the deformity with posterior instrumentation, and 360-degree spinal fusion with bone autograft.

Results. After surgery the angle of scoliotic deformity in patients with lateral hemivertebrae ranged from 6° to 14°, the degree of correction ranged from 82.3 % to 94.7 %. In patients with posterolateral hemivertebrae the angle of scoliotic deformity ranged from 0° to 9° (the degree of correction – from 86.7 % to 100.0 %), and the angle of kyphotic component – from 0° to 9° (the degree of correction – from 79.6 % to 100.0 %). The formation of solid bone block was noted in all patients at 1.5–2 years after surgery. There were no early or late postoperative complications and neurological disorders.

Conclusion. A combined approach to treat children with isolated vertebral anomalies in the thoracic spine including extirpation of the malformed vertebra and additional mobilization of the posterior spinal column provides a selective treatment approach and radical correction of the spinal deformity, the smallest number of fixed spinal motion segments, and prevention of internal organ complications.

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