Hemivertebra

What it is

A hemivertebra is a vertebra that formed as only half a wedge before birth, instead of a full rectangular block. Because it is wedge-shaped, it tilts the spine and is one of the most common causes of congenital scoliosis. It is present from birth and is not anyone’s fault.

What to expect

The effect depends on where the hemivertebra sits and whether another anomaly balances it out. A single, well-balanced hemivertebra may cause only a mild curve that never needs treatment. One that is unbalanced — or sits at the bottom of the spine where there is nothing below to compensate — is more likely to drive a curve that grows with your child.

How we follow it

X-rays show the wedge and the curve it creates, and an MRI checks the spinal cord. As with all congenital curves, I also look for related findings elsewhere and follow the curve closely during growth, since growth is what makes these curves progress.

How we treat it

A stable, balanced hemivertebra is often just monitored. When it is driving a progressive curve, the most direct treatment is to remove the malformed wedge (a hemivertebrectomy) and realign the spine, frequently with a short fusion of just the involved levels. Done early, while the curve is still small and flexible, this is often a focused operation that corrects the problem at its source.

The science — for the curious

Removing the hemivertebra at a young age has a real advantage: a small curve corrected over one or two levels avoids the much larger operation that a big, rigid curve would later require. This is the same principle that guides all of deformity care — the least surgery that solves the problem, done at the time it can be smallest — so the decision and its timing are tailored to your child’s specific anatomy and growth.

Learn more

Scoliosis Research Society — Scoliosis: srs.org

Scoliosis Research Society — Patient Brochures: srs.org/patients

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.