Update on congenital spinal deformities: preoperative evaluation.
METHODS
Review.


OBJECTIVE
To review and outline the preoperative evaluation and approach in assessing children with congenital vertebral malformation.


BACKGROUND
Congenital vertebral malformations encompass a broad spectrum of conditions. A high association of renal, cardiac, and intraspinal anomalies with congenital vertebral malformation has been well documented in the literature. Vertebral malformation with involvement of the thoracic cage may lead to the development of thoracic insufficiency. The natural history, the character, and location of the deformity ultimately influence the propensity for progression and the necessity for treatment. Multiple factors should be considered before treatment with the goal of treatment aimed at providing the best possible care to be able to optimize the child's overall function and potential for growth.


METHODS
Narrative and review of literature.


CONCLUSIONS
Congenital scoliosis is a multifaceted condition. The presentation of the condition can be quite varied from those presenting with an isolated hemivertebrae to those with severe malformations, complicated by multiple medical conditions. A thorough preoperative evaluation is necessary before the institution of any treatment protocol. The presence of any medical condition must be addressed; the treatment should be tailor-made for each patient putting into consideration the patients' age and the effects of treatment on pulmonary function at maturity.
Chan
Gilbert
G
Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Dormans
John P
JP
D000367:Age Factors; D002648:Child; D002985:Clinical Protocols / Q000592:standards*; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods* / Q000592:standards; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013121:Spinal Curvatures / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D035423:Thoracic Cavity / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D014781:Viscera / Q000002:abnormalities / Q000254:growth & development / Q000503:physiopathology