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Bristol, Ruth, et al. – Segmental spinal dysgenesis, a rare developmental malformation, usually manifests during pregnancy or at birth. The resulting gross spinal instability necessitates spinal stabilization, which is inherently challenging in neonates. We report four cases of segmental dysgenesis: three in the thoracolumbar region and one at the cervicothoracic junction. The latter was maintained in a custom orthosis that restricted all craniospinal motion while allowing routine care. Two neonates underwent surgical stabilization. The fourth patient will remain in a brace until 12-14 months old when fusion is planned

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