Surgical treatment for congenital scoliosis: biconcave uninstrumented poster fusion

Introduction: Congenital scoliosis is rare to find, and the treatment modalities are scarce and highly debatable. The goals of surgery are to arrest progression while maintaining a globally balanced spine and maximizing the potential for further growth. Although conservative approach is preferable, there are also proposed decisions for much aggressive managements. Case Report: We present a case of a 2-year-old girl with congenital scoliosis. With severe angle and symptoms developing from the deformity starting to take its toll, interventive treatment was indicated. A two-level biconcave, uninstrumented, posterior fusion was performed, together with bracing to complete the treatment. The deformity was corrected acutely. The patient was able to return to normal activities one week after the surgery. Although longer follow up should be done, this, however, could not be fulfilled because of the patient’s incompliance. The main striking drawback of instrumentation is the growing ability, as the characteristic of a child itself is growing. The child might outgrow the instrument over time. Thus, a staged approach should be done. A non-instrumentation procedure was performed, and bracing was originally taken to keep the curvature at bay. Conclusion: Children are much more prone to changes and this proneness to changes might as well be considered in the treatment. Thus, staged approach and careful monitor of growth is mandatory.