Challenging Case of Sitting Imbalance as an Indication of Surgery for Grotesque Congenital Deformity of Spine - A Case Report.

Introduction: Sitting imbalance due to spinal deformity as an indication of surgery is very rarely encountered.

Case report: We came across a very peculiar case of spinal deformity case who was wandering in search of treatment around multiple centers. The main concern for this 16-year-old boy from Yemen, who was born with congenital deformity with myelomeningocele and paraplegia, was sitting imbalance, which developed 2 months before presentation to our institute. Patient underwent a thorough clinical, radiological and multimodality assessment. Staged procedure of diastematomyelia excision followed by definitive posterior deformity correction was performed. Postoperatively, the patient's sitting balance was restored with no complications.

Conclusion: Sitting imbalance can be an indication of surgery with congenital complicated kyphoscoliosis. With proper planning and staged management, the sitting balance could be achieved.