Congenital scoliosis: a review and update.

Vertebral anomalies causing congenital scoliosis are classified on the basis of failures of formation, segmentation, or both. The natural history depends on the type of anomaly and the location of anomaly. Patient evaluation focuses on the history and physical examination, followed by appropriate imaging modalities. The hallmark of surgical treatment is early intervention before the development of large curvatures. The surgical treatment of a congenital deformity mandates the use of neurological monitoring to minimize the risk of perioperative neurological deficit. Modern surgical techniques have evolved to include the routine use of spinal instrumentation. Patients with associated chest wall deformities or large compensatory curves may be candidates for vertical expansion prosthetic titanium rib placement or growing rods insertion to maximize growth.