Congenital absence of the lumbar spine and sacrum: one-stage reconstruction with subsequent two-stage spine lengthening.

This is a case report of a child born with severe, type IV lumbosacral agenesis. At age 6 years, she had surgical reconstruction of her absent spine and thoracic-pelvic instability with Harrington rods and autogenous bone obtained from simultaneous bilateral knee disarticulations. This arthrodesis healed solidly, and at the age of 10 years 6 months and again at age 12 years 6 months, she underwent spine lengthening by osteotomy and distraction instrumentation, the first time with Moe rods and the second time with Cotrel-Dubousset rods. Both lengthening osteotomies healed without difficulty. The spine lengthening achieved was 5.0 cm.