Last revised by Mostafa Elfeky on 11 Jul 2023

Hemivertebra is a type of vertebral anomaly that results from a lack of formation of one half of a vertebral body. It is a common cause of congenital scoliosis

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

Recognized associations are many and include:

It falls under the spectrum of segmentation 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. 

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

  • 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-segmental

    • not separated 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

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 on either side of the vertebral column 5.

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

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


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