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Related Experiment Videos

Hemimetameric segmental shift: a case series and review.

Scott B Shawen1, Philip J Belmont, Timothy R Kuklo

  • 1Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.

Spine
|December 18, 2002
PubMed
Summary

Hemimetameric shift, a condition involving contralateral hemivertebrae, is a common finding in congenital scoliosis cases. Surgical intervention is most frequent when the anomaly affects the thoracolumbar or lumbosacral spine.

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Area of Science:

  • Orthopedics
  • Pediatric Spine Surgery
  • Radiology

Background:

  • Hemimetameric segmental displacement (hemimetameric shift) is characterized by two contralateral hemivertebrae separated by a normal vertebra.
  • This condition is infrequently detailed in medical literature, with no prior case series published.

Observation:

  • A case series identified 27 instances of hemimetameric shift among 186 congenital scoliosis patients (15%) between 1974 and 2000.
  • Patients presented with an average of 2.9 hemivertebrae, predominantly in the thoracic region.

Findings:

  • The average curve magnitude was 28 degrees, with surgical intervention required in nine patients, primarily those with thoracolumbar or lumbosacral junction involvement.
  • Associated anomalies were noted in eleven patients, including Klippel-Feil syndrome and imperforate anus. Magnetic resonance imaging revealed abnormalities in only 6% of cases.

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Implications:

  • Hemimetameric shift is a significant, though underreported, component of congenital scoliosis.
  • Understanding the distribution and surgical indications for hemimetameric shift aids in patient management.
  • The low incidence of MRI-detected anomalies suggests a limited role for routine advanced imaging in this specific condition.