Scoliosis and Other Congenital Vertebral Anomalies

Congenital vertebral malformations with scoliosis result from embryological defects in vertebral element formation or segmentation. Etiologies include genetic causes as well as environmental factors. Patients have an increased incidence of associated anomalies that involve cardiac, genitourinary, and neurological systems. Clinical significance of curve progression depends on the age at diagnosis, location of the curve, and the nature of the underlying vertebral malformation. Surgical intervention may be appropriate in younger patients with thoracolumbar deformities and specific vertebral anomalies. Surgical options include convex hemiepiphysiodesis, instrumented fusion, osteotomies and vertebrectomies, as well as growing systems. This chapter will discuss diagnosis, workup, and treatment strategies for congenital scoliosis.