What are congenital spine conditions?
Congenital spinal conditions are structural abnormalities of the spine that develop during fetal formation, typically in the first six weeks of pregnancy. Unlike idiopathic scoliosis — which develops during adolescence for unknown reasons — congenital spine deformities are caused by abnormal vertebral formation or segmentation.
The most common types include hemivertebrae — where a single vertebra forms incompletely on one side, causing a wedge-shaped vertebra that drives a scoliotic curve. Block vertebrae and unilateral unsegmented bars are also common, where vertebrae fail to separate normally, causing rigid curves that worsen predictably with growth.
Dr. Enguidanos has extensive experience treating congenital spinal conditions in both children and adults. His fellowship training at the University of Colorado Spine Center under Dr. Thomas Lowe included pediatric deformity cases. He serves families throughout the Florida Panhandle and Gulf Coast at HCA Florida Twin Cities Hospital in Niceville, Florida.
Common symptoms.
- Visible spinal curve or uneven shoulder and hip height noticed in infancy or childhood
- Rib or chest asymmetry
- Torticollis — tilting of the head and neck in cervical congenital conditions
- Progressive deformity with growth — often accelerating during growth spurts
- Back pain in older children and adults with uncorrected deformity
- Neurological symptoms if the spinal cord is involved — weakness, bowel or bladder changes
- Associated anomalies — congenital heart defects, kidney abnormalities, and Sprengel's deformity
- Short trunk height disproportionate to arm length in severe cases
What causes it.
- Failure of vertebral formation — hemivertebrae, wedge vertebrae
- Failure of vertebral segmentation — block vertebrae, unsegmented bars
- Mixed defects — combination of formation and segmentation failures
- Genetic syndromes — Klippel-Feil, VACTERL association, Jarcho-Levin
- Environmental factors during fetal development — not well characterized
- Maternal factors — diabetes, valproic acid exposure during pregnancy
When to call us.
Any child identified as having a congenital spinal anomaly on imaging — whether found during prenatal evaluation, newborn screening, or incidentally — should be evaluated by a spine specialist. The timing of intervention is critical and depends on the type of anomaly, the expected rate of progression, and the child's age.
Some congenital anomalies are balanced and require only observation. Others — particularly unilateral unsegmented bars opposite a hemivertebra — progress rapidly and require early surgical intervention before severe deformity develops.
Adults with untreated or partially treated congenital scoliosis who are experiencing progression or pain also warrant evaluation. Dr. Enguidanos sees both pediatric and adult patients with congenital spine conditions.