Keywords [eng] |
Congenital scoliosis, vertebral malformations, hemivertebra, kyphoscoliosis, growth modulation, thoracic insufficiency syndrome, convex hemiepiphysiodesis with concave distraction, imaging, epigenetic, multimodal imaging, AI |
Abstract [eng] |
Congenital scoliosis is a complex spinal deformity caused by a malformation of the vertebral bodies during embryonic development. It is often associated with other systemic anomalies. The prognosis depends largely on the type, location and number of malformations, as well as any associated intra-, or extraspinal pathologies. Early diagnosis is crucial, as the first years of life are considered to be a critical period for the course of the disease and can be decisive for the success of treatment. The therapeutic approach must be individually adapted to the individual child and be multidisciplinary in nature, this is the only way to take account of both structural features and functional needs. Growth-directed procedures such as convex instrumented hemiepiphyseodesis with concave distraction allow correction of the deformity while preserving thoracic and spinal growth. In the case of a 13-month-old child with multiple deformities and concomitant syringomyelia, the need for staged surgical intervention, including shunt implantation, hemivertebrectomy and pedicle subtraction osteotomy (PSO), was demonstrated to both secure neurological function and achieve structural correction. Complications such as implant failure highlight the importance of continuous imaging and a dynamic therapeutic approach. Forward-looking technologies such as AI-based image analysis, patient-specific 3D models and epigenetic research promise to further improve treatment planning and prognosis. Early detection and precise, personalised treatment are essential to avoid serious long-term consequences such as thoracic insufficiency syndrome (TIS) and to ensure long-term quality of life for affected children. |