Growth patterns in children with congenital vertebral anomaly.
METHODS
Height and weight data in children with congenital vertebral anomaly, recorded routinely during clinical follow-up, were analyzed.


OBJECTIVE
To determine whether these children are significantly deficient in growth or show an abnormality of maturation.


BACKGROUND
Structural abnormalities in the vertebral column, and surgery to prevent or correct deformity secondary to this, clearly have the potential to affect the individual's final height. It is not clear, however, whether this is the whole problem, or whether there are other factors to be considered.


METHODS
The height and weight of patients with all forms of spinal deformity are routinely recorded at outpatient visits. Data from patients with congenital vertebral abnormalities were analyzed and compared with the national standards. To test the possibility that the observed short stature might be familial, family groups (parents and siblings of patients) were invited to be measured.


RESULTS
At the end of growth, patients with congenital vertebral anomalies were smaller than average and also smaller than their parents and siblings. This was more marked in girls and in the presence of associated anomalies, especially when multiple, as in VACTERL association (vertebral, anal, cardiac, tracheal, esophageal, renal, and limb anomalies). It was also exacerbated by surgery, which had a demonstrable stunting effect on the spine.


CONCLUSIONS
Although shortening of the spine was demonstrated in patients with prior spinal surgery, the contributions of the fact of surgery and the presumed severity of anatomic abnormality could not be differentiated. The observations that, even without surgery, girls were generally on a lower percentile than boys and that both have a tendency to lose height at growth spurt invite further investigation.


CONCLUSIONS
The shortening of the spine by surgery is not a contraindication to treatment, because a straight, balanced spine must always be preferable to a longer, crooked and unbalanced one. However, it is another facet to be remembered when considering the management plan of the whole child.
Goldberg
Caroline J
CJ
Children's Research Centre, Diabetes and Endocrine Centre, Orthopaedic Department, Our Lady's Hospital for Sick Children, Dublin, Ireland. caroline.goldberg@ucd.ie
Fallon
Miriam C
MC
Moore
David P
DP
Fogarty
Esmond E
EE
Dowling
Frank E
FE
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000375:Aging; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006128:Growth / Q000502:physiology; D006801:Humans; D007494:Ireland; D008297:Male; D017678:Sex Distribution; D012741:Sexual Maturation; D013122:Spinal Diseases / Q000151:congenital* / Q000175:diagnosis / Q000503:physiopathology*; D013131:Spine / Q000002:abnormalities*