Comparative analysis of the results of correction of congenital spinal deformity in isolated semivertebrae in preschool and primary school-age children

BACKGROUND: Despite a detailed study of the natural development of congenital spinal deformity in isolated semivertebrae and methods of surgical correction of this pathology, some issues remain unclear. The age at which surgical correction of congenital spinal deformity should be performed is a debated issue among specialists.

AIM: To conduct a comparative analysis of the effectiveness of correction of spinal deformity in children with congenital kyphoscoliosis with isolated semivertebrae of preschool and primary school-age children.

MATERIALS AND METHODS: We included 26 patients aged 21 months to 69 months (10 girls and 16 boys) with congenital kyphoscoliosis caused by an isolated semivertebra. The patients underwent partial or complete resection of the semivertebral disk with adjacent intervertebral disks from dorsal or combined access, correction and stabilization of congenital spinal deformity with a posterior multisupport metal structure. Participants were sectioned into two age groups: the first group — children under 4 years (14 children), the second group — children 6 years and older (12 children).

RESULTS: Metal fixation during surgical treatment in children of primary school age as well as in preschool children was carried out in the majority of cases polysegmentarily. Regarding the choice of surgical treatment access, dorsal surgical access was more often preferred in the second group of patients. The duration of surgical intervention and volume of blood loss between different age groups were similar with dorsal and combined access. In the group of preschool children, destabilization of the metal structure was noted in the early postoperative period when performing control radiographs after surgical treatment in three cases. In the second group, spinal deformity of dysplastic genesis after surgical treatment was detected in three cases.

CONCLUSIONS: The effectiveness of surgical treatment of congenital deformity is significantly higher in younger children compared to that in school-age patients.