Types and Associated Anomalies of Congenital Scoliosis

Weon Wook Park; Seong Jun Ahn; Jeong Tae Kim; Keun Tak Suh

doi:10.4184/jkss.2001.8.3.202

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Park, Ahn, Kim, and Suh: Types and Associated Anomalies of Congenital Scoliosis

Original Article

Journal of Korean Spine Surg 2001;8(3):202-209.

Published online: 21 February 2001

DOI: https://doi.org/10.4184/jkss.2001.8.3.202

Types and Associated Anomalies of Congenital Scoliosis

Weon Wook Park, M.D., Seong Jun Ahn, M.D.^∗, Jeong Tae Kim, M.D.^∗, Keun Tak Suh, M.D.

Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan, Korea

^∗Department of Orthopaedic Surgery, Maryknoll Hospital, Pusan, Korea

Address reprint requests to Weon Wook Park, M.D. Department of Orthopaedic Surgery, College of Medicine, Pusan National University #1-10 Ami-dong, Seo-gu, Pusan 602-739, Korea Tel : 82-51-240-7246, Fax : 82-51-243-7273, E-mail : pww@scoliosis.co.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study design

A nalysis was based on radiographic appearance of 57 cases of congenital scoliosis and associated anomaly

Purpose

The aim of the present study was to assess the incidence, morphology and the associated anomalies of the congenital spinal scoliosis.

Summary of Literature Review

Hemivertebra is the most common type of congenital scoliosis and urogenital, musculoskeletal and cardiac anomalies are strongly associated.

Materials and Methods

The authors analysed the morphology and the associated anomalies of 57 cases of congenital scoliosis from 1994 to 2000.

Re su l ts

It was more common in male(32 males and 25 females). The bony anomalies were classified as failure of formation(40cases, 70.2%), failure of segmentation(11cases, 19.3%) and mixed type(6cases, 10.5%). Of the failure of formation, there were 36 cases(63.2%) of hemivertebra, 2 cases of posterior quadrant vertebra and 2 cases of wedge vertebra. We found associated anomalies in 26 patients(45.6%). A ssociated cardiac anomalies were 2 dextrocardia, ventricular septal defect, atrial septal defect and patent ductus arteriosus. A ssociated musculoskeletal anomalies were 5 rib fusion, 2 developmental dysplastic hip, 3 Klippel-Feil syndrome, A chondroplasia, A rnold- Chiari malformation, spinal dysraphism with sacral hair patch, cleft palate with congenital anklyloglossia. A ssociated neurogenic anomalies were 2 cases of syringomyelia and 3 mental retardation. There were unilateral renal agenesis and undescended testicle in urogenital anomalies.

Conclusion

Common type of the congenital scoliosis was hemivertebra(63.2%) caused by the failure of formation(70.2%). A ssociated anomalies were found in 26 patients(45.6%).

Keywords: Congenital scoliosis, Morphology, A ssociated anomalies

REFERENCES

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Figures and Tables%

Fig. 1-A.

Plain radiograph in 1988 shows right T6 hemivertebra fully segmented. Fig. 1-B. 10 years later(1998), the Cobb's angle was increased to 39 degrees.

Fig. 2.

Whole spine anteriorposterior view shows hemimetameric shift.

Fig. 3.

21-year-old-female with unilateral bar from T3-T11, the Cobb's angle was 122 degrees.

Fig. 4-A.

Whole spine anteriorposterior shows right L2 unincarcerated hemivertebra partially segmented. Fig. 4-B. Cervical spine lateral view shows fusion of C1-2 and C4-6 spine.

Fig. 5.

MRI shows left T12 hemivertebra with T7, 8 butterfly vertebra.

Fig. 6.

Distribution of Cobb's angle of hemivertebra and unilateral bar shows 32.1 degrees of the mean Cobb's angle in hemivertebra and 55.4 degrees in unilateral bar.

Table 1.

Associated anomalies in 26 patients with congenital scoliosis.

Cardiac anomalies(No. of patient)
Dextrocardia(2)	Ventricular septal defect(1)
Atrioseptal defect(1)	Patent ductus arteriosus(1)
Musculoskeletal anomalies(No. of patient)
Rib fusion(5)	Developmental dysplastic hip(2)
Klippel-Feil syndrome(3)	Arnold-Chiari malformation(1)
Spinal dysraphism & sacral hair patich(1)	Achondroplasia(1)
Cleft palate & congenital anklyloglossia(1)
Urogenital anomalies(No. of patient)
Unilateral renal agenesis(1)	Undescended testicle(1)
Neurogenic anomalies(No. of patient)
Mental retardation(3)	Syringomyelia(2)

Table 2.

Summary of vertebral anomalies

Type of anomaly(No. of patient)

Failure of formation(40)

Hemivertebra(36)

Single hemivertebra(25)

unincarcerated fully segmented(12)

unincarcerated semisegmented(11)

fusion to upper vertebra(8)

fusion to lower vertebra(3)

unincarcerated nonsegmented(2)

Multiple hemivertebra(11)

hemimetameric shift(5)

butterfly vertebra+semisegmented hemivertebra(2)

butterfly vertebra+full segmented hemivertebra(2)

ipsilateral multiple hemivertebra(2)

Posterior quadrant vertebra(2)

Wedge vertebra(2)

Failure of segmentation(11)

Lateral unilateral bar with scoliosis(11)

Mixed type(6)

Posterior quadrant vertebra+block vertebra+unilateral bar(1)

Hemivertebra+block vertebra(3)

Hemivertebra+block vertebra+unilateral bar(1)

Hemivertebra+unilateral bar(1)

Table 3.

The mean of Cobb's angle of hemivertebra and unilateral bar

Type of anomaly	location (No. of patient)	The mean of Cobb's angle
Hemivertebra	T^∗1-T4(1)	40
(full segmented)	T5-L^†1(8)	38.1
	L2-L4(3)	41
Hemivertebra	T1-4(1)	39
(semisegmented)	T5-L1(5)	22.2
	L2-L4(5)	24.4
Unilateral bar	T1-4(2)	32.5
	T5-L1(7)	66.3
	L2-L4(2)	40

^T∗ : thoracic spine; L^†: lum mbar spine

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