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Risk of Progression


- See:
      - Unilateral Bar:
      - Segmented Vertebrae:
- Discussion:
     - many pts have mild curves that are stable for years and then suddenly become severe when the adolescent growth spurt begins;
     - approx 75% of pts w/ Congenital Scoliosis will show progression, & approx 50% will progress significantly and require treatment;
     - two or more hemivertebrae on the same side are likely to result in scoliosis that progresses as the child grows.
     - when 2 hemivertebrae exist on opposite sides, scoliosis may be slight.
     - failure of development of the anterior portion of one or more vertebrae results in Kyphosis.
- Prognosis for progression of Congenital Scoliosis depends on type of congenital deformity present, its location in the spine, & age of pt
    at presentation.
    - worst prognosis:  Unilateral Bar w/ contralateral hemivertebra;
    - followed by    :          Unilateral Bar
    - followed by    :          double hemivertebra on same side
    - followed by    :          single hemivertebra
    - followed by    :          wedged hemivertebra
    - best prognosis :       block  hemivertebra
         - progressive spinal deformity is rarely produced by block vertebrae, which are 2nd to bilateral failure of segmentation