Rare congenital spinal malformation due to failure in the formation and fusion of vertebral body ossification nuclei, resulting in the development of only one side of the vertebral body.
M/C cause of congenital scoliosis
Findings: Laterally-based wedge vertebra with half a vertebral body, a single pedicle, and hemilamina.
M/C site: Midthoracic vertebrae (especially T8)
The radiographies and clinical pictures of patient 1. A 9-year-old female with three right-sided hemivertebrae at T5, 9 and 11 levels received hemivertebrae resection through a combined anterior and posterior approach. Besides hemivertebrae, the patient had left-sided sixth and seventh rib synostosis, and butterfly vertebrae at T6 and 10 levels. During the anterior surgery, the vertebral bodies of T9 and T11 were excised. In the posterior surgery, the appendix of T9 and T11, and the hemivertebrae at T5 were excised. The rib synostosis was severed. Right pedicle of T4 fractured when compression was applied to close the gap resulting from the resection of hemivertebra at T5 level. The fusion segments were extended to T3. a–c Preoperative anteroposterior and lateral radiographs show 56° main curve and 44° segmental kyphosis. Preoperative CT shows the configuration of hemivertebrae (arrows). d, e Postoperative anteroposterior and lateral radiographs show 7° main curve and 21° segmental kyphosis. f, g Anteroposterior and lateral radiographs taken 30 months after surgery show 7° main curve and 21° segmental kyphosis. h–j Preoperative clinical pictures of the patient. k–m Clinical pictures of the patient taken at the final follow-up | Zhou, C., Liu, L., Song, Y., Liu, H., Li, T., Gong, Q., … Kong, Q. (2014). Hemivertebrae resection for unbalanced multiple hemivertebrae: is it worth it?. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 23(3), 536–542. doi:10.1007/s00586-013-3065-1
Complication
Neurologic complication:
Result from severe angulation of the spine, narrowing of the spinal canal, instability of the spine, and luxation or fracture of the vertebrae.
Rear limb weakness/paralysis
Urinary/faecal incontinence
Spinal pain
Management
Surgical management:
Surgical spinal cord decompression and vertebral stabilization
