Congenital Vertebral Anomalies

Congenital vertebral anomalies are deformities of the spine that are present at birth. Some of these conditions cause abnormal alignment of the spine and others affect the nerves, causing problems in moving the arms or legs, bathroom issues or pain.

Many congenital spinal deformities relate to spina bifida. Babies born with spina bifida aperta or myelomeningocele may have an open defect on their backs. In this area, the skin over the spinal cord does not form properly, and the nerves are exposed. Spina bifida occulta is a condition that is not as severe as an open defect—children may have abnormalities in the spine, which may or may not cause symptoms.

Other common congenital vertebral anomalies include:

Tethered spinal cord. A tethered spinal cord is a neurological condition that stretches the spinal cord like a rubber band. This happens when abnormal tissue attachments limit the movement of the spinal cord. A number of conditions may cause this, but it is closely related to spina bifida (myelomeningocele), abnormal fat in the spinal cord (lipomyelomeningocele) or other deformities. In some cases, a tethered spinal cord is related to a tighter than normal connection (the filum terminale) between the spinal cord and the tailbone.
Abnormal spinal alignment. Abnormalities in spinal alignment may cause pain, loss of function and breathing restriction. An abnormal alignment may be described as:
- Kyphosis. Bone deformities cause the spine to bend forward.
- Lordosis. The spine bends too far backwards.
- Scoliosis. Abnormal bones make the spine bend sideways.

Symptoms of congenital spine deformities vary depending on a child’s specific condition. Typical symptoms include:

Pain
Numbness
Tingling
Difficulty walking
Difficulty sitting
Breathing problems
Bathroom issues (accidents, incontinence, constipation)
Infections

Diagnosis of Congenital Vertebral Anomalies

Doctors at Riley Children's perform the following exams and tests to diagnose congenital spine abnormalities:

Clinical exam. A neurosurgeon will examine your child to check his or her back and spine to look for the specific signs of misalignment or lesions.
Imaging tests. A neurologist will recommend different imaging tests. These tests help understand what is happening to your child’s spine and vertebrae. Imaging tests used include:
- Computed tomography (CT) to create images of the spinal column and spinal cord
- Magnetic resonance imaging (MRI) to see the tissues and structures of the spinal cord
- EOS to see how the spine aligns when your child is in an upright position
Urology exam. If your child is diagnosed with a tethered spinal cord, the neurosurgeon may recommend seeing a urologist. The urologist will evaluate your child’s bladder function.

Treatments

There are many treatment options for children with spinal birth defects. Treatment focuses on reducing pain, restoring function and correcting harmful abnormalities. Your child’s prognosis will depend on the severity of his or her condition.

Bracing. Some children with congenital scoliosis respond well to the use of a brace, which keeps the spine in alignment as the child grows
Surgery. There are many types of surgical options for congenital spine abnormalities. Many patients see real benefits after surgery and regain lost functions.
- Scoliosis surgery. The three common surgeries performed for scoliosis are spinal fusion surgery (spine is fused together), growing rod surgery (rods are placed in the spine with the ability to lengthen as the spine grows) and non-fusion surgery (places screws in the spine).
- Tethered spinal cord surgery. There are multiple options for surgically treating children with a tethered spinal cord. The spine itself may be shortened to relieve stress on the nerves. In select patients, the nerves may be freed by detaching them from scar tissue, fat or by releasing a tight strand of tissue that extends from the end of the spinal cord to the tail bone (filum terminale).

Key Points to Remember

Congenital spine abnormalities are disorders of the spine that are present at birth.
Many congenital spine abnormalities are related to spina bifida.
Other common congenital spine anomalies include tethered spinal cord and abnormal spinal alignment, such as kyphosis, lordosis and scoliosis.
Symptoms vary depending on the specific condition but can include pain, numbness, tingling, difficulty walking and bathroom issues.
There are many treatment options for children with congenital spine abnormalities, including bracing and surgery.

Support Services & Resources

Visit the links below to discover support groups and more resources for congenital spine abnormalities.

We offer a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

National Institute of Neurological Disorders and Stroke

The National Institutes of Health provide more information about the symptoms, treatment and research related to tethered spinal cord.

Spina Bifida Association

This site includes information about the congenital spine abnormalities associated with spina bifida.

Congenital Spine Abnormalities Research

Pediatric neurosurgeons at Riley Children's are responsible for much of the research related to the treatment and management of tethered spinal cord syndrome, including protocols for selecting patients who will respond well to surgery, advances in neuronavigation technology and precise measurement of the impact on a child’s quality of life.