Modified Woodward Procedure for Sprengel’s Deformity with Omovertebral Extension into the Spinal Canal in an 8-Year-Old Child

Abstract

Sprengel’s deformity is a rare congenital anomaly characterized by failure of normal scapular descent during embryologic development. It is frequently associated with omovertebral connections and may result in significant cosmetic deformity and functional limitation. Surgical treatment is indicated for moderate-to-severe cases to improve shoulder function and symmetry. An 8-year-old child presented with congenital elevation of the scapula associated with marked shoulder asymmetry and restricted abduction. Imaging demonstrated Sprengel’s deformity with an omovertebral bone extending toward the spinal canal, without neurological deficit. Preoperative evaluation was performed to define the anatomy and guide surgical planning. Sprengel’s deformity with omovertebral extension into the spinal canal represents a complex variant that requires meticulous surgical dissection to avoid neurovascular injury. The modified Woodward procedure provides a muscle-sparing technique that allows controlled inferior translation of the scapula with reduced risk of brachial plexus traction. Adjunct procedures, such as clavicular modification, may further facilitate scapular mobilization in rigid deformities, particularly in older children. The modified Woodward procedure is a safe and effective technique for managing Sprengel’s deformity, even in complex cases with omovertebral extension. Careful preoperative imaging and precise surgical technique are essential to achieve optimal functional and cosmetic outcomes.