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Update on congenital spinal deformities: preoperative evaluation
1Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Insights
A thorough preoperative evaluation is essential for children with congenital vertebral malformations. This approach optimizes treatment and growth potential by considering associated anomalies and individual patient factors.
Area of Science:
- Pediatric Orthopedics
- Developmental Biology
- Medical Genetics
Background:
- Congenital vertebral malformations present a wide spectrum of conditions.
- Associated renal, cardiac, and intraspinal anomalies are common.
- Thoracic cage involvement can lead to thoracic insufficiency.
Purpose of the Study:
- To review and outline the preoperative evaluation for children with congenital vertebral malformation.
- To emphasize a comprehensive approach to assessing these complex cases.
Main Methods:
- Narrative review of existing literature.
- Synthesis of current knowledge on preoperative assessment.
Main Results:
- Congenital scoliosis is complex, with varied presentations.
- Thorough preoperative evaluation is critical before treatment.
- Associated medical conditions must be addressed.
Conclusions:
- Treatment must be individualized based on patient age and potential pulmonary function at maturity.
- Optimizing overall function and growth potential is the primary goal.
- Tailored treatment plans are essential for managing congenital vertebral malformations.
Study Design:
Review.
Objective:
To review and outline the preoperative evaluation and approach in assessing children with congenital vertebral malformation.
Summary Of Background Data:
Congenital vertebral malformations encompass a broad spectrum of conditions. A high association of renal, cardiac, and intraspinal anomalies with congenital vertebral malformation has been well documented in the literature. Vertebral malformation with involvement of the thoracic cage may lead to the development of thoracic insufficiency. The natural history, the character, and location of the deformity ultimately influence the propensity for progression and the necessity for treatment. Multiple factors should be considered before treatment with the goal of treatment aimed at providing the best possible care to be able to optimize the child's overall function and potential for growth.
Methods:
Narrative and review of literature.
Conclusion:
Congenital scoliosis is a multifaceted condition. The presentation of the condition can be quite varied from those presenting with an isolated hemivertebrae to those with severe malformations, complicated by multiple medical conditions. A thorough preoperative evaluation is necessary before the institution of any treatment protocol. The presence of any medical condition must be addressed; the treatment should be tailor-made for each patient putting into consideration the patients' age and the effects of treatment on pulmonary function at maturity.
