Background: A single lumbar hemivertebra can be expected to cause
progressive scoliosis. The aim of this study was to evaluate the results of a
lumbar hemivertebra resection and short-segment fusion through a combined
posterior and anterior approach.
Methods: From 1987 to 2002, a consecutive series of twenty-one
patients with congenital scoliosis or kyphoscoliosis due to a lumbar
hemivertebra were managed by resection of the hemivertebra through a combined
posterior and anterior approach and with the use of a short anterior and
posterior convex-side fusion.
Results: The mean age at the time of surgery was 3.3 years (range,
twelve months to 10.2 years). The mean followup period was 8.6 years. There
was a mean improvement of 71.4% in the segmental scoliosis curve from a mean
angle of 32.9° before surgery to 9.4° at the time of the latest
follow-up assessment, and a mean improvement of 63.9% in the global scoliosis
curve from 34.1° to 12.3°. The mean final lordosis was within normal
Conclusions: Excision of a lumbar hemivertebra is safe and provides
stable correction when combined with a short-segment fusion. Surgery should be
performed as early as possible to avert the development of severe local
deformities and prevent secondary structural deformities that would require a
more extensive fusion later.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.