Surgical treatment of congenital Sprengel deformity with omovertebral bone: A case report of an 8-year-old girl

Abstract

Sprengel deformity is a rare congenital anomaly resulting from failed caudal migration of the scapula during embryonic development. In selected patients, an omovertebral bone may forms a rigid osseous tether between the cervical spine and scapula, restricting scapulothoracic motion and contributing substantially to functionl impairment. We report the case of an 8-year-old girl with left-sided Cavendish grade III Sprengel deformity who presented with limited shoulder elevation and a well-corticated omovertebral bone extending from the C4 spinous process to the superomedial scapular angle. Computured tomography provided detailed visulization of the morphology, orientation, thereby facilitating precise surgical planning. The patient underwent targeted posterior excision of the osseous tether without intraoperative or postoperative complications. At the six-month follow-up, marked improvement in shoulder elevation, enhanced scapular symmetry, and excellent cosmetic and functional recovery were observed. This case underscores the mechanical significance of the omovertebral bone in Sprengel deformity and supports anatomy-guided isolated excision as an effective treatment option in carefully selected pediatric patients in whom the deformity is predominantly driven by a discrete osseous connection.

Keywords

• : Sprengel deformity
• omovertebral bone excision
• scapulothoracic dyskinesis
• congenital scapular elevation
• Caverdish

References

1. Pisani R. Sprengel's deformity: a case report and review of the literature. 2022. WT G. The surgical correction of congenital elevation of scapula (Splengel's deformity). Proceeding of the American Orthopaedic Association. J Bone Joint Surg, A. 1957;39:1439.
2. Woodward JW. Congenital elevation of the scapula: Correction by release and transplantation of muscle origins. jbjs. 1961;43(2):219–28.
3. Walstra FE, Alta TD, van der Eijken JW, Willems WJ, Ham SJ. Long-term follow-up of Sprengel's deformity treated with the Woodward procedure. J Shoulder Elbow Surg. 2013;22(6):752–9.
4. Patwardhan S, Sodhai V, Gugale S, Sancheti P, Shyam A. Surgical correction of Sprengel's deformity by modified Woodward procedure: outcomes in twenty eight patients. Int Orthop. 2020;44(6):1143–51.
5. Harvey EJ, Bernstein M, Desy NM, Saran N, Ouellet JA. Sprengel deformity: pathogenesis and management. J Am Acad Orthop Surg. 2012;20(3):177–86.
6. Gillespie B, Shaw BA, Waters P. Surgical Excision of an Omovertebral Bone in an Adult with Untreated Sprengel Deformity: A Case Report. JBJS Case Connect. 2013;3(4):e96.
7. Ahmed AF, Lohre RS, Elhassan BT. Surgical Treatment of Sprengel's Deformity in Adolescents and Adults. Jbjs Open Access. 2025;10(1).
8. Doita M, Iio H, Mizuno K. Surgical management of Sprengel's deformity in adults. A report of two cases. Clin Orthop Relat Res. 2000(371):119–24.

9. Zarantonello P, Di Gennaro GL, Todisco M, et al. Surgical Treatment of Sprengel's Deformity: A Systematic Review and Meta-Analysis. Children (Basel). 2021;8(12).