DESCRIPTION
Hemivertebra describes a rare congenital spinal deformity where a section of a vertebra fails to develop typically resulting in a wedge shape. The condition can cause the spine to become unbalanced and develop a curve resulting in scoliosis and/or kyphosis. The severity of hemivertebra is dependent on its affect on the spine’s alignment and its degree of attachment to the vertebrae above and below.
CAUSES
Hemivertebra occurs as a result of improper formation of a vertebra during fetal development. However, the exact cause of a vertebra’s improper development is unknown.
SYMPTOMS
Children with hemivertebra rarely experience pain which can lead to the condition remaining undetected until it becomes severe enough to cause spinal instability or a scoliosis curve.
DIAGNOSIS
Upon suspicion of a hemivertebra, x-rays would be ordered to identify the location and number of hemivertebra. Additional CT scans may be ordered to provide detailed clearer images of the condition and MRI scans may be ordered to rule out other deformities.
TREATMENT
Mild non-progressive curves caused by hemivertebra are typically treated non-surgically and just observed. However, bracing has proven ineffective in managing hemivertebra.
Surgical treatment of a hemivertebra involves removal of the deformed vertebra and can be performed on children ranging in age from infants to adolescents. Under general anesthesia, an incision is made on the back, the hemivertebra is removed, and the vertebrae above and below are fused together. The child may have to wear a brace after surgery until the spine heals.
Sources
- Weerakkody, Y et al. (n.d.). Hemivertebra. Radiopaedia.org. Retrieved July 23, 2014, from http://radiopaedia.org/articles/hemivertebra
- Letts, R.M. (n.d.). Congenital Spinal Deformity. Medscape.com. Retrieved July 23, 2014, from http://emedicine.medscape.com/article/1260442-overview
- Scoliosis in Children. (n.d.). USCSpine.com. Retrieved July 23, 2014, from http://www.uscspine.com/conditions/childrens-scoliosis.cfm
- Hedequist, D. J., & Emans, J. B. (n.d.). Hemivertebra Excision. Inkling.com. Retrieved July 23, 2014, from https://www.inkling.com/read/operative-techniques-orthopaedic-surgery-vol-2-1st/chapter-peds-63/hemivertebra-excision
- Early Onset Scoliosis. (n.d.). SRS.org. Retrieved July 23, 2014, from http://www.srs.org/patient_and_family/scoliosis/early_onset_scoliosis/treatment/hemivertebra_resection.htm
