1. Non-surgical treatment
The most common non-surgical treatment of congenital scoliosis is observation, which is only suitable for cases with unclear natural history. Observation can play a certain role in hemivertebra or mixed deformity, but it is not suitable for patients with unilateral osteopontin formation. Observation method: Follow-up once every 4 ~ 6 months, and routine anteroposterior X-ray examination of spine standing, and prone X-ray examination is feasible for infants who can't stand.
The indications of brace therapy are limited, and it is suitable for patients who are immature, gradually deformed and have long and soft lateral bending segments. Cases without progress do not need braces, and are not suitable for cases with automatic improvement of deformity. For short and stiff segments, brace treatment is almost ineffective.
2. Surgical therapy
(1) Posterior in-situ fusion refers to posterior spinal fusion without internal fixation instruments, which is suitable for isolated or short-segment unilateral bone bridge or hemivertebra before typical deformity. The age is.
(2) Convex bone marrow mass is suitable for patients with unilateral dysplasia, such as fully decomposed hemivertebra deformity. By inhibiting the protruding bone marrow and the growth endplate, the growth potential of the concave side is retained.
(3) Posterior instrumentation orthopedic fusion is often used for older or severely deformed congenital scoliosis.
(4) Hemivertectomy can directly remove the teratogenic factors, and it can be divided into two types: anterior-posterior combined one-stage or two-stage hemivertectomy and posterior hemivertectomy.
(5) Spinal osteotomy is usually applied to patients with pelvic tilt, trunk decompensation, progressive deformity and spinal nerve abnormality. Combined with hemivertebra resection and instrument orthopedic fusion, serious deformity can be corrected
(6) The growth rod technique is divided into single rod technique and double rod technique for early progressive scoliosis.
(7) Thoracoplasty with vertical expansion and titanium rib prosthesis are suitable for early congenital malformation with vertebral body deformity and rib fusion. Through chest wall incision or rib resection, continuous expansion of artificial ribs were placed to correct chest deformity.