Segmental Spinal Aplasia: Anatomical Variations and Treatment Insights

Area of Science:

• Spinal surgery
• Pediatric orthopedics
• Congenital spinal anomalies

Background:

• Segmental spinal aplasia (SSA) comprises a spectrum of congenital anomalies affecting spinal development, often presenting in early childhood.
• Understanding the anatomical variations and associated complications of SSA is crucial for effective management.

Purpose of the Study:

• To analyze the anatomical variants of segmental spinal aplasia (SSA).
• To investigate factors influencing surgical treatment outcomes in SSA patients.
• To determine the incidence of complications associated with SSA treatment.

Main Methods:

• Retrospective cohort study of patients with SSA treated at a single medical center.
• Neurological function assessed using the modified Japanese Orthopedic Scale (mJOA).
• Functional independence measured by the Functional Independence Measure (FIM/WeeFIM); complications and reoperations documented.

Main Results:

• SSA predominantly localized at the thoracolumbar junction, often with spinal cord narrowing and low conus medullaris.
• Cervicothoracic SSA associated with segmentation disorders (P = .04).
• High complication rates: 17% early (wound, neurological deterioration), 34% late (non-fusion); 38% required revision surgery.

Conclusions:

• SSA is a progressive condition requiring careful management.
• Surgical intervention, while sometimes necessary for neurological decline, carries significant risks.
• Conservative management options should be considered due to high surgical complication rates.