Scoliosis secondary to a hemivertebra: seven patients with gradual improvement without treatment.

STUDY DESIGN

Retrospective case series.

OBJECTIVE

To make clinicians aware of this unusual natural history.

SUMMARY OF BACKGROUND DATA

Nonprogressive and progressive scolioses due to hemivertebrae have been abundantly documented in the literature. There has been no article describing spontaneous improvement. Two case reports have been described elsewhere in a general article on natural history.

METHODS

From a previous review of 1250 patients with congenital spine deformity of all types, 7 patients were identified with spontaneous improvement of their scoliosis due to a hemivertebra during growth.

RESULTS

The mean curve at start of observation was 31 degrees (range: 24 degrees -43 degrees), and at the end of observation was 19 degrees (range: 10 degrees -30 degrees). Six of the curves were at the thoracolumbar region (T11-L2), and the other at T1. The average duration of follow-up was 9 years.

CONCLUSION

Spontaneous curve improvement is rare, but possible. In view of the difficulty of prediction for curves due to a hemivertebra, careful observation with careful curve measurement is recommended. Inappropriate early, aggressive surgery should be avoided.