THE CHOICE OF SURGICAL APPROACH FOR CONGENITAL SPINAL DEFORMITY CAUSED BY MULTIPLE VERTEBRAL MALFORMATIONS
Objective. To perform retrospective review of the natural history of spinal deformities caused by multiple vertebral malformations and to develop an algorithm for surgical correction with regard to a leading malformation. Material and Methods. Treatment results in 94 patients aged 5 months to 33 years with congenital spinal deformities and multiple vertebral malformations were reviewed. Surgery was performed in 81 patients who were followed-up for 6 months to 5 years. Vertebral and thoracic syndromes, neurological dynamics, and functional disorders were evaluated. An algorithm for detection of the leading malformation was applied to predict a natural course of spinal deformity associated with multiple malformations and to choose a surgical approach. Results. Patients were divided into four groups depending on the type of multiple vertebral anomalies: monosegmental (isolated), polysegmental, outspread multiple, and complicated. The approach to choosing of surgical tactics was offered. Conclusion. Indications for surgical treatment of spinal deformities caused by multiple vertebral malformations appear to be life-saving. Surgical treatment for this cohort of patients may be performed only after comprehensive examination. The identification of leading malformation is necessary to determine the volume of surgical intervention. Hir. Pozvonoc. 2014;(2):21-28.