Hemivertebrae

Hemivertebrae

Hemivertebrae is a congenital malformation of vertebras. It is characterized by fusion or defective development of vertebral bodies where one-half of the vertebral bodies is absent causing spine deformity.

Causes and risk factors

The exact cause of the disorder is unknown, but it is believed to be due to neurological problems. The normal vertebrae have cylindrical bodies.  The defect in formation of vertebra leads to assymetrical arrangement of vertebra causing a wedge shape. Diseases associated with this condition include Aicardi syndrome, gastroschisis, Gorlin syndrome, fetal pyelectasis, Jarcho-Levin syndrome, etc.

Clinical presentation

Patient presents with pain in back, discomfort while walking, sitting, and standing. Limb weakness is observed. There is an angulation in spine. Angulation is at midthoracic vertebra causing scoliosis or lordosis. There is narrowing of spinal cord sometimes causing compression. Signs and symptoms like urinary incontinence or fecal incontinence is experienced. The condition is classified according to its attachment such as – fully segmental, i.e., not attached to any of the vertebra, semi segmental – half segment fused with above or below vertebra, nonsegmental – not separated from above or below vertebra, incarcerated – joined by pedicles with above or below vertebra.  It is also classified as per its orientation such as dorsal resulting in kyphosis, lateral causing scoliosis or ventral hemivertebra leading to lordosis.

Investigation

Medical history by the patient and clinical examination by the doctor helps in diagnosis. X-ray of spine is done. CT scan is advised. Antenatal ultrasound is done.

Treatment

Treatment involves bracing, traction. Medical treatment includes analgesics, NSAIDs for symptomatic relief. Surgery is useful in treating the condition. Vertebral stabilization and spinal decompression is helpful. Physiotherapy will contribute further to the treatment.

Facts and figures

Incidence of hemivertebrae is 3 per 10,000 live births.

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