This post is an update to the 3-30-2021 post on a 4-year-old with severe, complex, mixed-type of congenital scoliosis.
The major problem for this young patient (4 years old) who has two adjacent hemivertebra which is at the junction of the thoracic spine (chest) and the lumbar spine. These two hemivertebra cause an acute, severe deformity.
The management of this problem involved resection of the hemivertebra (x 2) and fusion over the severely involved section of the spine. Though there is instrumentation which goes high and low in the spine, these screws are Shilla screws, so they are not fused and will slide up and down the spine as the patient grows.
The patient underwent 1 revision surgery for loosening of a couple screws and soft tissue irritiation at 1 year after her first, primary surgery
Below is now 4 years out after her primary surgery and 3 years after the revision surgery. The patient is doing well, no back pain, is growing and doing the activities they want to do as an 8 year old!
The amount of spine growth, due to the complex, mixed type congenital scoliosis is far less than a normal patient. However, if you look below at the amount of rod protruding beyond the screws (red at top, yellow at bottom), the length of the rods are less and this means the spine is growing!
There are no surgeries planned at this point in time and seeing us in the outpatient clinic about every 6 months. There is no need for surgical lengthenings or outpatient remote-control lengthenings. The patient is functioning like a normal 8-year-old!