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Hemivertebra

Hemivertebra is a type of vertebral anomaly and results from a lack of formation of one half of a vertebral body. It can be a common cause of a congenital scoliosis/kyphosis or a lordosis

Epidemiology

The estimated incidence is at ~0.3 per 1000 live births 2.

Pathology

It falls under the spectrum of segmentational anomalies and can involve one or multiple levels.

A hemivertebra acts as a wedge within the vertebral column, resulting in curvature away from the side on which it is present. 

Associations

Recognised associations are many and include:

This list supposed to be lot longer than this. If you know more, do add in with a relevant journal reference.

Classification

A hemivertebra can be classified according to many types which include:

Attachment
  • fully segmental (free)
    • not attached to either vertebra above or below
    • most concerning
  • semi segmental: half segment is fused with vertebra above or below with no intervening intervertebral disc
  • non segemental
    • not seperated from (i.e. connected to) either level above or below
    • causes less of a concern
  • incarcerated
    • joined by pedicles to levels above and below
    • causes less of a concern
Orientation 

Radiographic features

Antenatal ultrasound

A hemivertebra may be seen as an asymmetrical vertebral body on sagittal or coronal scanning, while on axial scanning, a focal defect may be seen at either side of the vertebral column 5.

Plain film/CT

Usually directly outlines the bony anomaly and often seen as a wedge shaped vertebral body.

Prognosis

The prognosis can be variable dependant on the type from being a progressive to non progressive deformity. The strongest negative impact is when a hemivertebra occurs at the lumbo-sacral level 7.

Differential diagnosis

For antenatal sonographic appearances consider:


Related articles

Spinal anatomy

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