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Abstract

Background: The etiology, severity and prognosis of congenital scoliosis depend on multiple factors, with limited data in the literature. There is also limited data on surgical correction based on the underlying vertebral anomaly. Given the progressive nature of the disease and eventual need for surgical intervention, the study was designed to obtain more data, assess disease presentation and progression in relation to environmental and physical characteristics, and evaluate surgical predictors to elucidate the disease and understand its prognosis in relation to various factors.

Methods: Using a retrospective chart review, we created a database for patients with congenital scoliosis seen at the Carrie Tingley Hospital in Albuquerque, NM from 2002 to 2011. This includes information on patient age, ethnicity, geographical location, degree of spinal curvature(s) using the Cobb method, vertebral anomaly(ies), and surgical intervention(s) and outcomes. Data was analyzed using ANOVA, and simple and logistic regressions.

Results: Of the 125 patients recorded, mean age at presentation was 4 years and 9 months and mean length of follow-up was 5 years. We found a statistically significant relationship between age at presentation and scoliosis severity and found that the most common underlying vertebral anomaly was hemivertebrae, which was associated with a better prognosis and a negative predictor for surgery. Thoracic anomalies were associated with worse prognosis.

Conclusion: Many factors influence the severity and progression of congenital scoliosis. With future studies elucidating effective interventions, it will be necessary to screen at a younger age given the direct correlation between age and disease severity. Certain anatomical traits can predict a better or worse prognosis, and thus can aid in management and provide a better quality of life.

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