Hemivertebra

Changed by Owen Kang, 15 May 2017

Updates to Article Attributes

Body was changed:

Show markup changes

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.

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 a 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 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

Orientation

dorsal hemivertebra: classically results in kyphosis
lateral hemivertebra: classically results in scoliosis
ventral hemivertebra (extremely rare): results in lordosis

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 on either side of the vertebral column ⁵.

Plain radiograph / CT

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

Treatment and prognosis

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

Differential diagnosis

-<p><strong>Hemivertebra</strong> is a type of <a href="/articles/vertebral-anomalies">vertebral anomaly</a> and results from a lack of formation of one half of a vertebral body. It can be a common cause of a congenital <a title="Scoliosis" href="/articles/scoliosis">scoliosis</a>. </p><h4>Epidemiology</h4><p>The estimated incidence is at ~0.3 per 1000 live births <sup>2</sup>.</p><h4>Pathology</h4><p>It falls under the spectrum of segmentational anomalies and can involve one or multiple levels.</p><p>A hemivertebra acts as a wedge within the vertebral column, resulting in curvature away from the side on which it is present. </p><h5>Associations</h5><p>Recognised associations are many and include:</p><ul>
+<p><strong>Hemivertebra</strong> is a type of <a href="/articles/vertebral-anomalies">vertebral anomaly</a> and results from a lack of formation of one half of a vertebral body. It can be a common cause of a congenital <a href="/articles/scoliosis">scoliosis</a>. </p><h4>Epidemiology</h4><p>The estimated incidence is at ~0.3 per 1000 live births <sup>2</sup>.</p><h4>Pathology</h4><p>It falls under the spectrum of segmentational anomalies and can involve one or multiple levels.</p><p>A hemivertebra acts as a wedge within the vertebral column, resulting in curvature away from the side on which it is present. </p><h5>Associations</h5><p>Recognised associations are many and include:</p><ul>
-</ul><p><em>This list supposed to be lot longer than this. If you know more, do add in with a relevant journal reference.</em></p><h5>Classification</h5><p>A hemivertebra can be classified according to many types which include:</p><h6>Attachment</h6><ul>
+</ul><p><em>This list supposed to be a lot longer than this. If you know more, do add in with a relevant journal reference.</em></p><h5>Classification</h5><p>A hemivertebra can be classified according to many types which include:</p><h6>Attachment</h6><ul>
~~-<a href="/articles/dorsal-hemivertebra">dorsal hemivertebra</a>: classically results in a <a title="Kyphosis" href="/articles/kyphosis">kyphosis</a>~~
+<a href="/articles/dorsal-hemivertebra">dorsal hemivertebra</a>: classically results in <a href="/articles/kyphosis">kyphosis</a>
~~-<a href="/articles/lateral-hemivertebra">lateral hemivertebra</a>: classically results in a <a title="Scoliosis" href="/articles/scoliosis">scoliosis</a>~~
+<a href="/articles/lateral-hemivertebra">lateral hemivertebra</a>: classically results in <a href="/articles/scoliosis">scoliosis</a>
~~-<a href="/articles/ventral-hemivertebra">ventral hemivertebra</a> (extremely rare): results in a <a title="lordosis" href="/articles/lordosis">lordosis</a>~~
+<a href="/articles/ventral-hemivertebra">ventral hemivertebra</a> (extremely rare): results in <a href="/articles/lordosis">lordosis</a>
-</ul><h4>Radiographic features</h4><h5>Antenatal ultrasound</h5><p>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 <sup>5</sup>.</p><h5>Plain radiograph / CT</h5><p>Usually directly outlines the bony anomaly and is often seen as a wedge shaped vertebral body.</p><h4>Treatment and prognosis</h4><p>The prognosis can be variable dependant on the type of segmentation anomaly, from being a progressive to a non progressive deformity. The strongest negative impact is when a hemivertebra occurs at the lumbo-sacral level <sup>7</sup>.</p><h4>Differential diagnosis</h4><ul>
~~-<li><a title="Block vertebrae" href="/articles/block-vertebra">block vertebrae</a></li>~~
~~-<li><a title="Bullet shaped vertebra" href="/articles/bullet-shaped-vertebra">bullet shaped vertebrae</a></li>~~
~~-<li><a title="Butterfly vertebrae" href="/articles/butterfly-vertebra">butterfly vertebrae</a></li>~~
+</ul><h4>Radiographic features</h4><h5>Antenatal ultrasound</h5><p>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 <sup>5</sup>.</p><h5>Plain radiograph / CT</h5><p>Usually directly outlines the bony anomaly and is often seen as a wedge-shaped vertebral body.</p><h4>Treatment and prognosis</h4><p>The prognosis can be variable dependant on the type of segmentation anomaly, from being a progressive to a non progressive deformity. The strongest negative impact is when a hemivertebra occurs at the lumbo-sacral level <sup>7</sup>.</p><h4>Differential diagnosis</h4><ul>
+<li><a href="/articles/block-vertebra">block vertebrae</a></li>
+<li><a href="/articles/bullet-shaped-vertebra">bullet shaped vertebrae</a></li>
+<li><a href="/articles/butterfly-vertebra">butterfly vertebrae</a></li>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":17197,"studyId":6888,"caseSlug":"congenital-scoliosis-secondary-to-hemivertebrae","caption":"Case 1","thumbnail":"https://prod-images-static.radiopaedia.org/images/17197/d4951e843b21b897d1a2b518fcb91b_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":29313,"studyId":38750,"caseSlug":"hemivertebra-with-congenital-scoliosis-1","caption":"Case 2","thumbnail":"https://prod-images-static.radiopaedia.org/images/29313/2c2f135f0965cf6a2b915df012366b_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":3984528,"studyId":23460,"caseSlug":"lateral-hemivertebra","caption":"Case 3: T3 right lateral hemivertebra","thumbnail":"https://prod-images-static.radiopaedia.org/images/3984528/64bbe23b0e461aebee06b3cfc78218_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":2441897,"studyId":19844,"caseSlug":"hemivertebra","caption":"Case 4","thumbnail":"https://prod-images-static.radiopaedia.org/images/2441897/6a0c979cf37d1aeb714d7dc5b89388_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":17932477,"studyId":44383,"caseSlug":"fused-hemivertebra","caption":"Case 5","thumbnail":"https://prod-images-static.radiopaedia.org/images/17932477/9b8ca76140ec4db99b55b4311e5cdc_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":44426776,"studyId":73584,"caseSlug":"lumbar-hemivertebra","caption":"Case 6: lumbar hemivertebra","thumbnail":"https://prod-images-static.radiopaedia.org/images/44426776/18a0ebfc318e917f52042055206b36_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":54574602,"studyId":103965,"caseSlug":"thoracic-hemivertebra-deformity","caption":"Case 7; Dorsal hemivertebra deformity","thumbnail":"https://prod-images-static.radiopaedia.org/images/54574602/kyphosis.PNG_angle_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":55609072,"studyId":109678,"caseSlug":"congenital-scoliosis-4","caption":"Case 8","thumbnail":"https://prod-images-static.radiopaedia.org/images/55609072/IM0015_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":59596124,"studyId":126291,"caseSlug":"sprengel-deformity-13","caption":"Case 9","thumbnail":"https://prod-images-static.radiopaedia.org/images/59596124/06977b848a55c2d995ab2640d4d45aface7d30a90cfa3118833e3490e20ed4df_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[],"lang":"us"}