Dorsal hemivertebrae in children's lumbar spines

Area of Science:

• Pediatric Orthopedics
• Spinal Surgery
• Congenital Spinal Deformities

Background:

• Dorsal hemivertebrae are rare congenital spinal deformities.
• The natural history and risk of neurologic impairment are unpredictable.
• Associated conditions include spina bifida and sacral agenesis.

Purpose of the Study:

• To present two cases of congenital dorsal hemivertebra with progressive lumbar kyphosis.
• To discuss the onset and outcomes of surgical treatment.
• To evaluate the effectiveness of surgical decompression and fusion.

Main Methods:

• Clinical examination, radiography, and MRI were used for follow-up.
• One patient underwent a dorsal approach with hemivertebra resection and fusion.
• The other patient received conservative management with serial follow-up.

Main Results:

• Surgical resection and fusion reversed progressive spasticity in one patient.
• Spinal alignment and canal width normalized post-surgery.
• The non-operative patient remained neurologically intact, with surgery planned if indicated.

Conclusions:

• A posterior surgical approach is recommended for dorsal hemivertebra.
• Resection and short fusion effectively decompress the spinal canal.
• Early surgery is crucial to prevent long-term neurologic deficits.