Treatment of congenital scoliosis in an 8-month-old child.

Congenital scoliosis due to fully segmented hemivertebrae is most often progressive and requires treatment. Currently, the operative treatment recommended includes (a) posterior spinal fusion with or without instrumentation and (b) anterior and posterior exposure with fusion, epiphysiodesis or hemivertebral excision. We report the case of a patient who was operated on at the age of 8 months by a single-stage posterior approach with a transpedicular hemivertebral resection and convex hemepiphysiodesis combined with a low-profile posterior unilateral instrumentation. The goals were the prevention of progression, potential correction by growth on the concave side, short hospital stay, reduction in the morbidity associated with a separate anterior approach, and no need for postoperative bracing. Preliminary results after a follow-up period of 2 years support the impression that this approach bears significant advantages compared to previously preferred anteroposterior procedures.