Abstract
Cervico-thoracic congenital scoliosis is a difficult deformity to obtain good correction due to its anatomical characteristics and lack of proper instrumentation. Surgical treatments often end up with poor correction by convex epiphysiodesis alone, making hideous residual head tilt. This is a report of 2 cases with cervico-thoracic congenital scoliosis, which underwent total excision of hemivertebra, instrumentation and fusion through posterior approach alone.
Case 1. 8y2m old Girl who had T1, T3, T7 hemivertebrae with a left convex curve from C7 to T11. At age 5. she had tilted head and left convex 33 degrees scoliosis. Only regular observation was done. At age 8y2m, the scoliosis had progressed to 49degrees. Total excision of T1 hemivertebra was performed. At age 10y8m, total excision of T7 hemivertebra, extension of instrumentation and fusion to T10 was performed. These procedures brought almost normal alignment on both sagittal and coronal plane. However, lower compensatory curve progressed later on, fusion was extended to L2 at age 13 resulting in excellent balance.
Case 2: Girl. 2y7m. Multi-level hemivertebrae. C6-L1 L100 degrees.
Total excision of T12 hemi, short fusion and instrumentation reduced the scoliosis to 50 degrees. Five months later, total excision of T9 hemi was done. Four months later, concave side instrumentation from T2 to L2 without fusion was done. At age 4y2m, total excision of T1 hemi was done using cervical pedicle screw. The scoliosis is being controlled at 35 degrees with one extension of the rod later on.
Correspondence should be addressed to: Dr Caroline Goldberg, The Research Centre, Our Lady’s Children’s Hospital Crumlin, Dublin 12, Ireland.
