Congenital kyphoscoliosis correction; Hemivertebra excision, deformity correction and posterior instrumented fusion


Subscribe to get full access to this operation and the extensive Spine Surgery Atlas.


Learn the Congenital kyphoscoliosis correction; Hemivertebra excision, deformity correction and posterior instrumented fusion surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Congenital kyphoscoliosis correction; Hemivertebra excision, deformity correction and posterior instrumented fusion surgical procedure.

A congenital scoliosis results from a vertebral anomaly causing an imbalance in the longitudinal growth of the spine and subsequent curvature. While the vertebral anomalies are present at birth, the deformity may not be diagnosed until later in life. The vertebral anomalies develop during the first 6 weeks of intrauterine life, arising from a disruption of somitogenesis, which results in either a failure of formation of the vertebra, failure of vertebra segmentation or a combination of both processes. The pattern of deformity seen and the potential for progression depends on the type of anomaly present, its location within the spine, the magnitude of deformity, the patient’s age and whether the curves are single or multiple.

The prevalence of congenital scoliosis is approximately 1 in 1000 live births. A scoliosis is the most common deformity (80%) followed by kyphoscoliosis (14%) and isolated kyphosis (6%).

The aetiology of congenital kypho-scoliosis is multifactorial; environmental factors, genetics, vitamin deficiency, chemicals and drugs have all been implicated, either singly or in combination.

Congenital kyphotic deformities are far less common than congenital scoliotic deformities but can have serious consequences. They produce a sagittal plane deformity characterised by abnormal posterior convex angulation of a segment of the spine. They are caused by developmental vertebral anomalies that impair longitudinal growth, anterior or anterolateral to the transverse axis of vertebral rotation in the sagittal plane.

Congenital kyphosis is related to increased neurological risks if untreated. Spinal cord related problems may occur early, but are more common seen during the adolescent growth spurt.

Vertebral malformations in congenital kyphoscoliosis are classified as per the congenital scoliosis; failure of formation, failure of segmentation mixed patterns and unclassifiable. The failure of formation can be purely anterior, resulting in pure kyphosis, or anterolateral resulting in a kyphoscoliosis.

The majority of congenital kyphotic deformities are due to a failure of formation and its rate of progression may be 2.5 – 5 degrees per year. Most patients clinically deteriorate during adolescent growth spurt. Early detection allows for comprehensive patient evaluation, family discussions and preparation/ planning of future treatments depending on the predicted progression of the spinal deformities.



Author:Neil Upadhyay FRCS (Tr & Orth).

Institution: The Avon Orthopaedic Centre, Bristol,UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


  • Did you find this technique helpful?
  • YesNo

Lessons Status


Logo Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo