Congenital kyphosis

Definition

 

Kyphosis due to congenitally anomalous vertebrae

- characterized by severe angular deformity

- can be associated with paraplegia

 

Classification

 

Type I - Failure of formation	Type II - Failure of segmentation	Type III - Mixed
Hemivertebrae / wedge vertebrae Most common	Anterior unsegmented bar
Progressive severe deformity	Better prognosis Deformity progresses slowly

 

Clinical Features

 

Kyphosis may be obvious at birth

- worsen during adolescent growth spurt

- can progress in adulthood

 

Can compress abdominal organs and impair respiratory function

 

Imaging

 

 

 

Management

 

Bracing

 

Ineffective

 

Preoperative

 

MRI - exclude intraspinal pathology

Echocardiogram - cardiac abnormality

Abdominal ultrasound - renal abnormality

 

Operative

 

A.  < 5 years & curve < 50^o  - posterior spinal fusion

B.  > 5 years and > 50⁰ - anterior and posterior fusion