Congenital kyphosis in myelomeningocele. Vertebral body resection and posterior spine fusion.

The deforming mechanisms in the congenital lumbar kyphosis of myelomeningocele are situated anteriorly. Posterior wedge resection with local fusion therefore will not prevent progression of the deformity. Nonetheless, this procedure may be the only method of affording sac closure, or providing continuity of the ulcerated integument. Definitive corrective surgery will be required later and must combat the anterior deforming forces. Resection of the apical vertebral body followed by posterior fusion with Harrington instrumentation provides a solid straight spine.