Table 1 Follow - up of surgically treated patients with Congenital Scoliosis

Elsebai

2011

19 children

(7 males, 12 females)

Mean age: 6.9 years

5 failure of segmentation

4 failure of formation

5 mixed

5 unclassified

VEPTR

5 years

(2 to 7 years)

Preoperative mean Cobb angle:66°

(range: 40 - 95°)

Postoperative mean Cobb angle: 45°

(range: 18 - 78⁰ )

No neurological complications

14 complications at 8 pts

5 rod breakage

3 proximal construct dislodgment

2 implant failures

1 painful protruding anchor

2 pulmonary complications

1 postop deep infection

Takayama

2009

8 children

(3 males, 5 females)

Mean age:13.7 years

Posterior fusion

Harrington instrumentation:7

Dweyer: 1

23.1 years

Preoperative mean Cobb angle:54.5°

Postoperative mean Cobb angle: 30.5°

Cobb angle at the recent follow up: 36.8°

Loss of correction: 6.3°

SF - 36 Questionnaire score

Physical function: 49.4

Role physical: 51.1

Bodily pain: 47.8

General health: 49.1

Vitality: 47.6

Social function: 57.1

Role-emotional: 55.0

Mental health: 51.8

SRS-22 Total score

Function/activity: 4.20

Pain:4.45

Self-image appearance:3.48

Mental health: 3.93

Satisfaction with management: 3.75

Ruf 2009

41 children

19 males, 22 females

Mean age: 3.5 years

Range: 1.5 - 7 years

Children without bar formation

28 pts, 31 hemivertebrae

T1 - T9: 7 pts

T10 - L2: 18 pts

L3 - L4: 6 pts

All were non incarcerated,

19 fully segmented,

12 semisegmented

Children with bar formation

13 pts, 20 hemivertebrae

5 pts with double hemivertebrae

1 pt with 3 hemivertebrae on the same side,

10 pts with controlateral rib synostosis,

Thoracic spine: 10 pts,

Thoracolumbar spine: 2 pts,

Lumbar spine: 1 pt

Hemivertebrae resection by a posterior approach and transpedicular instumentation

6.5 years

Children without bar formation

Preoperative mean Cobb angle: 36.1°

Postoperative mean Cobb angle: 7.1°

Cobb angle at the recent follow - up: 6.8°

Children with bar formation

Preoperative mean Cobb angle: 69.2°

Postoperative mean Cobb angle: 23.3°

Cobb angle at the recent follow - up: 20.8°

Children without bar formation

No neurologic complications

Implant failure in 3 cases

(revision performed),

Children with bar formation

No neurologic complications

Revisions performed in 3 pts due to haematomas, deep infection, development of new deformities,

In one pt the rods were removed because of increased lordosis

Winter 2009

7 children

4 males, 3 females

Mean age: 7 years

Range: 1 - 17 years

All the patients had segmentation defects

Thoracic spine: 3 pts,

Thoracolumbar spine: 2 pts,

Lumbar spine: 2 pts

5 treated with posterior spine fusion,

2 left untreated

50 years

Preoperative mean Cobb angle: 66.5°

Postoperative mean Cobb angle: 41.8°

Cobb angle at the recent follow - up: 49.3°

Neck pain in 1 pt,

Signs of cor - pulmonale in 1 pt,

Low back pain and shoulder pain in 1 pt,

Chen 2009

21 children,

8 males, 13 females

Mean age: 20.1 years

Range: 12 -42 years

20 pts with single level hemivertebrae,

1 pt with hemivertebrae and controlateral unsegmental bar,

Thoracic spine: 7 pts,

Lumbar spine: 14 pts

19 treated with posterior instrumentation fusion,

2 combined with anterior hemivertebrae excision

9 years

Range:

3 - 18 years

Preoperative mean Cobb angle: 45.28°

Postoperative mean Cobb angle: 32.57°

Cobb angle at the recent follow - up: 36°

No neurological complications,

Low back pain in 3 pts,

Not successful curve correction in 3 pts,

Loss of reduction in 1 pt,

Broken screws in 1 pt

Vitale 2008

21 children

9 males, 12 females

Mean age: 4.9 years,

Range: 1 - 10 years

Hemivertebrae: 11 pts,

Unsegmented bar: 1 pt

Complex: 9 pts

Above the thoracolumbar junction: 12 pts,

Below the thoracolumbar junction: 9 pts

3 treated with posterior in situ fusion,

3 treated with posterior spinal fusion+ instrumentation,

7 treated with PSF+ instrumentation,

7 treated with in situ fusion anterior and posterior,

1 treated with anterior fusion + instrumentation

7 years

Range: 3 - 13 years

Preoperative mean Cobb angle: 53.6°

Cobb angle at the recent follow - up:

In pts with thoracic fusion: 41.6°

In pts with not thoracic fusion: 4.4°

Pulmonary Function Tests(PFT)

FVC: 74.4%

FEV: 73%

LTC: 88.5%

VC: 75.6%

Child Health Questionnaire(PF-28)

Physical functioning: 78.3

Social behavioral role: 88.8

Social-physical role: 90.4

Bodily pain/discomfort:71.4

Global behavior: 74.4

Mental health: 76.9

Self-esteem: 82.1

General health perceptions: 59.3

Physical summary: 44.5

Psychosocial summary: 50.6

Parental impact - emotional:68.4,

Parental impact time: 85.7,

Family activities: 84.5

Family cohesion: 67.6

Bollini 2006

34 children

16 males, 18 females

Mean age: 3.5

Range: 1 - 9.8 years

Hemivertebrae in all pts

Fully segmented: 12

Semi segmented: 22

Thoracic spine: 3 pts

Thoracolumbar spine: 21 pts

Lumbar spine: 10 pts

Hemivertebrae resection by double approach

7.1 years

Range:

2 - 14.6 years

Preoperative mean Cobb angle: 40.4°

Postoperative mean Cobb angle: 24.6°

Cobb angle at the recent follow - up: 26.9°

Postoperative complications

Paraparesis in1 pt/reoperation,

Wound infection in 2 pts,

Respiratory infections in2 pts,

Pneumothorax in 1 pt,

Pleural effusion in 1 pt

Late complications

Abdominal wall hernia in 1 pt,

Pseudarthrosis in 5 pts,

Breakage of the Harrington rod in 1 pt,

Grafting revision in 2 pts,

Sepsis / implant removal in 1 pt,

Progression of the curve in 6 pts,

Progressive kyphosis in 1 pt

(treated with vertebral osteotomy and arthrodesis),

Implant removal in 11 cases

Winter 2004

1 child

(case report)

Male

12 months

Unilateral unsegmented bar with nonsegmentation of the ribs at the same side,

Thoracic Spine(T4 - T7)

Posterior spine fusion

44 years

Preoperative mean Cobb angle: 37°

Postoperative mean Cobb angle: 28°

Cobb angle at the recent follow - up: 32°

VC: 70%,

Neck pain with slightly weak left deltoid,

Low back pain,

Multilevel degenerative changes in the lumbar spine

Marks 1995

53 children

27 males, 26 females

Mean age: 6.5 years

Range: 2 - 12 years

30 pts with fully segmented non-incarcerated hemivertebrae,

4 pts with unsegmented bars,

7 pts with unsegmented bars with hemivertebrae,

12 pts with complex types

Thoracic spine: 33,

Thoracolumbar spine: 11,

Lumbar spine: 10

Lumbo-sacral: 1

Anterior and posterior convex epiphysiodesis

9 years

Range: 3 - 22.5 years

Unilateral unsegmented bars

Preoperative mean Cobb angle: 47.5°

Cobb angle at the recent follow - up: 74.5°

Unilateral unsegmented bars and hemivertebrae

Preoperative mean Cobb angle: 49°

Cobb angle at the recent follow - up: 52°

Hemivertebrae

Preoperative mean Cobb angle: 41°

Cobb angle at the recent follow - up: 35°

Complex anomalies

Preoperative mean Cobb angle: 74°

Cobb angle at the recent follow - up: 90°

Neuroapraxias in 3 pts

(1 of an intercostals neure and 2 of the lateral cutaneous neure of the thigh)