Congenital dislocated spine: implications for orthopaedic management

Area of Science:

• Pediatric Orthopedics
• Spinal Surgery
• Developmental Biology

Background:

• Congenital dislocation of the spine (CDS) is a rare developmental anomaly affecting a single spinal level.
• New research defines CDS as distinct from multilevel spinal pathologies.
• Effective management necessitates experienced pediatric spine surgeons in specialized centers.

Purpose of the Study:

• To propose a comprehensive orthopedic management strategy for CDS.
• To detail the operative technique for treating CDS.
• To present findings from 6 new pediatric cases of CDS.

Main Methods:

• Retrospective review of patients with congenital spinal anomalies.
• Inclusion criteria based on embryologic theories: single-level involvement, sagittal displacement, intact spinal cord.
• Analysis of demographic data, clinical history, plain radiographs, CT, and MRI.

Main Results:

• Six children diagnosed with CDS between 1993 and 2007.
• Mean follow-up of 9.8 years for surviving patients.
• All patients achieved solid spinal fusion without deformity progression; two became independent walkers.

Conclusions:

• Neurological deficits in CDS result from associated spinal cord malformations, not mechanical factors.
• Therapeutic strategy adaptation can prevent secondary neurological damage.
• Early diagnosis, parental counseling, and prompt surgical stabilization with fusion are crucial.