Complex Congenital Scoliosis treated by Dr. Amrithlal Mascarenhas

A 14-year old girl presented to our Neurologist with complaints of progressive difficulty in walking since one month.  Clinical examination revealed overactive reflexes and slightly reduced motor power in both her legs.  The clinical diagnosis turned out to be an inflammation of the spinal cord.  An MRI of the spine showed a rare congenital deformation of the spine called hemivertebra with outward and lateral curvature of the upper thoracic spine with severe compression of the spinal cord.  The patient was advised an urgent consultation with our spine surgeon Dr. Amrithlal, but she failed to follow the advice and came back only after 2 months.  By then, the neurological deficits had progressed and she was unable to even stand up without support.  The patient was counselled for surgery and a CT scan was done to get a grip on the anatomy of the upper thoracic spine.  The surgery was done and pedicle screws were inserted into the vertebra to correct the deformity, both outward and lateral curvature of the spine was corrected.  The entire surgery was done under spinal cord neuro monitoring using MEP and SSEP at every stage of the surgery.

Postoperatively, the patient improved symptomatically.  She was able to walk with support on the second post operative day.  Outward curvature of the spine was corrected from 80 to 25 degrees and lateral curvature from 60 to 30 degrees which improved her gait.



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