Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis
Abstract Purpose The natural history of congenital scoliosis (CS) caused by hemivertebra varies greatly. This study aimed to explore the association between the morphology of hemivertebra and the severity of CS, since the diagnosis of the hemivertebra. Methods Patients with isolated (single fully se...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07193-8 |
| _version_ | 1797276213709897728 |
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| author | Tianhua Rong Yang Jiao Yizhen Huang Erwei Feng Heng Sun Junduo Zhao Jianxiong Shen |
| author_facet | Tianhua Rong Yang Jiao Yizhen Huang Erwei Feng Heng Sun Junduo Zhao Jianxiong Shen |
| author_sort | Tianhua Rong |
| collection | DOAJ |
| description | Abstract Purpose The natural history of congenital scoliosis (CS) caused by hemivertebra varies greatly. This study aimed to explore the association between the morphology of hemivertebra and the severity of CS, since the diagnosis of the hemivertebra. Methods Patients with isolated (single fully segmented) hemivertebra were enrolled. The degree and progression of deformity were compared by three morphological parameters of hemivertebra, comprising whether the width of hemivertebra extends across the central vertical line of lower adjacent vertebra (midline); the lateral height ratio (LHR, lateral height of hemivertebra× 2/(lateral height of HV-1 plus HV + 1) with the cut-point being 0.9; and the sagittal position of hemivertebra that was divided into the lateral and posterolateral group. Results In total, 156 patients (mean age 9.7 ± 6.2 years, 81 males) were enrolled. The number of thoracic, thoracolumbar (T12/13-L1), and lumbar hemivertebrae were 63, 41, and 52, respectively. Hemivertebrae across the midline had larger scoliosis and kyphosis (58.3 ± 20.6° vs. 42.8 ± 15.0°, P < 0.001; 45.1 ± 32.5° vs. 29.5 ± 25.7°, P = 0.013, respectively). Hemivertebrae with LHR ≥0.9 was associated with larger scoliosis (55.7 ± 20.6° vs. 41.4 ± 13.3°, P < 0.001). Larger scoliosis and kyphosis were observed in posterolateral hemivertebrae (54.4 ± 21.0° vs. 44.4 ± 15.6°, P = 0.026; 51.4 ± 31.5° vs. 20.6 ± 17.1°, P < 0.001, respectively). Co-occurrence of more than one of the three positive parameters above indicated higher annual progression (5.0 ± 2.2° vs. 3.3 ± 1.3°, P < 0.001). Conclusion Three positive parameters, width across the midline, LHR ≥0.9, and posterolateral position were associated with a more severe deformity in patients with isolated hemivertebra. Hemivertebrae with more than one positive parameter may cause progressive deformity, and thus need prompt surgery. Level of evidence Prognostic, level IV. |
| first_indexed | 2024-03-07T15:25:09Z |
| format | Article |
| id | doaj.art-c098c308357c4ce8ae0e75ab60b2defe |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-07T15:25:09Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-c098c308357c4ce8ae0e75ab60b2defe2024-03-05T17:24:38ZengBMCBMC Musculoskeletal Disorders1471-24742024-02-0125111110.1186/s12891-024-07193-8Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosisTianhua Rong0Yang Jiao1Yizhen Huang2Erwei Feng3Heng Sun4Junduo Zhao5Jianxiong Shen6Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceAbstract Purpose The natural history of congenital scoliosis (CS) caused by hemivertebra varies greatly. This study aimed to explore the association between the morphology of hemivertebra and the severity of CS, since the diagnosis of the hemivertebra. Methods Patients with isolated (single fully segmented) hemivertebra were enrolled. The degree and progression of deformity were compared by three morphological parameters of hemivertebra, comprising whether the width of hemivertebra extends across the central vertical line of lower adjacent vertebra (midline); the lateral height ratio (LHR, lateral height of hemivertebra× 2/(lateral height of HV-1 plus HV + 1) with the cut-point being 0.9; and the sagittal position of hemivertebra that was divided into the lateral and posterolateral group. Results In total, 156 patients (mean age 9.7 ± 6.2 years, 81 males) were enrolled. The number of thoracic, thoracolumbar (T12/13-L1), and lumbar hemivertebrae were 63, 41, and 52, respectively. Hemivertebrae across the midline had larger scoliosis and kyphosis (58.3 ± 20.6° vs. 42.8 ± 15.0°, P < 0.001; 45.1 ± 32.5° vs. 29.5 ± 25.7°, P = 0.013, respectively). Hemivertebrae with LHR ≥0.9 was associated with larger scoliosis (55.7 ± 20.6° vs. 41.4 ± 13.3°, P < 0.001). Larger scoliosis and kyphosis were observed in posterolateral hemivertebrae (54.4 ± 21.0° vs. 44.4 ± 15.6°, P = 0.026; 51.4 ± 31.5° vs. 20.6 ± 17.1°, P < 0.001, respectively). Co-occurrence of more than one of the three positive parameters above indicated higher annual progression (5.0 ± 2.2° vs. 3.3 ± 1.3°, P < 0.001). Conclusion Three positive parameters, width across the midline, LHR ≥0.9, and posterolateral position were associated with a more severe deformity in patients with isolated hemivertebra. Hemivertebrae with more than one positive parameter may cause progressive deformity, and thus need prompt surgery. Level of evidence Prognostic, level IV.https://doi.org/10.1186/s12891-024-07193-8Isolated hemivertebraCongenital scoliosisMorphological analysisProgressionObservation |
| spellingShingle | Tianhua Rong Yang Jiao Yizhen Huang Erwei Feng Heng Sun Junduo Zhao Jianxiong Shen Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis BMC Musculoskeletal Disorders Isolated hemivertebra Congenital scoliosis Morphological analysis Progression Observation |
| title | Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis |
| title_full | Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis |
| title_fullStr | Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis |
| title_full_unstemmed | Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis |
| title_short | Morphological analysis of isolated hemivertebra: radiographic manifestations related to the severity of congenital scoliosis |
| title_sort | morphological analysis of isolated hemivertebra radiographic manifestations related to the severity of congenital scoliosis |
| topic | Isolated hemivertebra Congenital scoliosis Morphological analysis Progression Observation |
| url | https://doi.org/10.1186/s12891-024-07193-8 |
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