Surgical Treatment of Spinal Pathology in Children with Caudal Regression Syndrome: Analysis of Long-Term Outcome

Abstract

Objective. To analyze long-term outcomes of surgical treatment of spinal column pathology in children with caudal regression syndrome. Material and Methods. The study included 12 patients aged 1.5 to 9 years with caudal regression syndrome. The Renshaw classification was used to determine the type of caudal regression. Surgery involved correction of kyphotic deformity of the spine and elimination of instability, and spinal-pelvic fusion including instrumented fixation of the vertebro-pelvic segment with restoration of the sagittal profile and support ability of the spine and creation of bone block by installing split cortical allografts along the spinal implant. Results. Children with types III and IV caudal regression syndrome underwent spinal-pelvic fusion, which allowed achiev- ing strong fixation of the vertebro-pelvic segment and ensured its stability at patient’s verticalization. Conclusion. Multi-anchor transpedicular instrumentation in combination with spinal-pelvic fusion with cortical allografts allows eliminating abnormal kyphosis, achieving bone block formation, and retaining the achieved result in the late post- operative period.

Keywords

• caudal regression syndrome
• sacral agenesis
• lumbosacral agenesis
• spinal-pelvic instability
• surgical treat- ment
• children