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. 2019 May;9(3):260-265.
doi: 10.1177/2192568218779984. Epub 2018 Jun 10.

Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome

Sergei Vissarionov  1   2 , Josh E Schroder  3   2 , Dmitrii Kokushin  1 , Vladislav Murashko  1 , Sergei Belianchikov  1 , Leon Kaplan  3
Affiliations

Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome

Sergei Vissarionov et al. Global Spine J. 2019 May.

Abstract

Study design: Retrospective cohort.

Objective: To analyze the outcome of surgical correction of children with caudal regression syndrome.

Methods: The study included 12 patients aged 1.5 to 9 years with caudal regression syndrome. In order determine the type of caudal regression, the Renshaw Classification was used. The surgery included correction and stabilization of the kyphotic deformity at the unstable lumbosacral region, with reconstruction of the sagittal balance using a bony block constructed from allograft. Short- and long-term outcomes were evaluated. The study was approved by the local institutional review board.

Results: Children with types III and IV caudal regression syndrome underwent spinal-pelvic fusion, with 100% fusion rate, which allows sufficient stabilization of the lumbopelvic segment permitting patient mobilization and standing in type III patients. There were 5 complications needing additional care.

Conclusion: Multilevel pedicular screw fixation in combination with spinopelvic fusion with cortical allografts allows reconstruction of the sagittal alignment with solid bony fusion improving the quality of life for these patients.

Keywords: caudal regression syndrome; children; lumbosacral agenesis; sacral agenesis; spinopelvic instability; surgical treatment.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Renshaw sacral agenesis classification. (A) type I; (B) type II; (C) type III; (D) type IV.
Figure 2.
Figure 2.
Method for measuring the magnitude of kyphotic deformity of spinopelvic segment in children with caudal regression syndrome.
Figure 3.
Figure 3.
Admission spine and pelvis computed tomography scans in patients with caudal regression syndrome on admission: (a) Patient E, 2-year-old child with type III caudal regression syndrome; (b) Patient S, 1.5-year-old child with type IV caudal regression syndrome.
Figure 4.
Figure 4.
Long-term follow-up spine and pelvis computed tomography scans in patients with caudal regression syndrome: (a) Patient E, 6-year-old child with type III caudal regression syndrome, 4 years after surgery; (b) Patient S, 5-year-old child with type IV caudal regression syndrome, 3.5 years after surgery.
Figure 5.
Figure 5.
Clinical pictures of a sacral agenesis case: (A) top and (B) side views prior to fixation. (C) After implant placement and bone graft placement.
See this image and copyright information in PMC

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