Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome

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.