Congenital Malformation of Spine

Congenital spine Abnormalities, Congenital Malformation, Congenital spine Deformities

• What Is Congenital Malformation of Spine?
• What Is Congenital spine deformities?

1. Congenital Malformation of Spine also called Congenital deformities or Congenital spine Abnormalities.
2. Congenital Malformation of Spine are disorders of the spine that develop in an individual prior to birth.
3. The vertebrae do not form correctly in early fetal development and in turn cause structural problems within the spine and spinal cord. These Malformations can range from mild to severe and may cause other problems if left untreated, such as developmental problems with the heart, kidneys and urinary tract, problems with breathing or walking, and paraplegia (paralysis of the lower body and legs).

Symptoms of Congenital Malformation

Doctors often detect any Congenital Malformation  at birth some spine deformities until later in childhood. Physical signs of congenital spine deformities typically include:

• Tilted pelvis
• Difficulty walking
• Difficulty breathing
• Abnormal curvature or twisting in the back, left or right, forward or backward
• Uneven shoulders, hips, waist or legs
• Respiratory complication
• Abnormal development of the spine can cause significant scoliosis, kyphosis, or lordosis, resulting in body deformities that can be distressing to patients and their families.
• The most serious threat of this problem  is the adverse effect of abnormal development of the spine on the  pulmonary function.

Diagnostic Procedures

• X-Rays are useful for showing structural deformities such as hemivertebrae, butterfly vertebra, or incomplete fusion of posterior elements.
• X-ray is used if no imaging of the spinal cord is required. For scoliosis, erect, posterior-anterior, frontal and/or lateral views (with breast shielding) are usually obtained.
• MRI is most frequently used for imaging of the spine in adults as the spinal canal and its content can be analysed easily.
• CT Scans continue to be the preferred method for the assessment of localised bony abnormalities, or a calcified component of the spinal canal, foramina, neural arches, and articular structures.
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Treatment

• Nonoperative treatment options
  • Nonoperative treatment options typically include pain medication, certain braces and physiotherapy (that includes gait and posture training).

• Surgery: Different types of ssurgeries are recommended for patients based on problem  at vertebral column.
  • Growing Rod Surgery: Growing rod surgery is one of the options for the correction of scoliosis, a modern alternative treatment for young children with early onset scoliosis. The incidence of complication remained relatively low and is also recommended for patients where the primary problem is at the vertebral column.
  • Expansion Thoracostomy and VEPT: For severe congenital spine deformations, when a large amount of growth remains, expansion thoracostomy and VEPTR (a curved metal rod designed for many uses), are the most appropriate choice. Used when the primary problems involve the thoracic cage, eg when there are rib fusions and/or with developing Thoracic Insufficient Syndrome,
  • Resection and Fusion: For treating congenital scoliosis caused by hemivertebra, posterior hemivertebra, resection and monosegmental fusion appears to be effective. This treatment results in an excellent correction in both the frontal and sagittal planes.  Early surgery is typically prescribed as a treatment for children with congenital scoliosis, even though there is little evidence for its long-term results.
  • Physiotherapy:The ICF has underscored the need for therapists to provide a holistic approach to treatment, focusing not only on exercises, stretches, and what a child is unable to do, but also on the child’s abilities. The approach to therapy is functional and questions whether a child can actively participate with his or her current level of function.

A physiotherapy assessment is required for children with early onset scoliosis to enable them to function to their fullest potential within society. Assessments provide a baseline for future interventions and establish goals that are appropriate and achievable for the child and the family within their environment.