Hemivertebra: Prenatal Diagnosis, Incidence and Characteristics

Abstract

Objective: Hemivertebra is a rare congenital spinal anomaly where only one side of the vertebral body develops, resulting in deformation of the spine, such as scoliosis, lordosis, or kyphosis. We aimed to determine the incidence and clinical characteristics of hemivertebra. Patients and Methods: We present three fetuses with a prenatal ultrasonographic diagnosis of hemivertebra at 15–22 weeks’ gestation, and we determine the incidence and clinical characteristics of hemivertebra among 78,500 live-born infants at a tertiary medical center in Israel. Results: There were 26 cases of hemivertebra (0.33/1,000 live-born infants): male/female ratio 1/1, Jewish/Arab ratio 10/16, and ratio of single/multiple type of hemivertebrae 17/9. Twenty-three out of 26 infants (88.5%) with hemivertebra had additional congenital anomalies (cranial, cardiac, renal, intestinal, and skeletal). Conclusions: Hemivertebra is not an infrequent finding in fetuses and live-born infants. Comprehensive ultrasonographic screening of the fetus allows early prenatal diagnosis of hemivertebra, and provides parents with helpful information for their decision regarding the fate of pregnancy.

Prenatal Sonographic Diagnosis of Hemivertebrae

“…The mean birth weight was 2335 ± 998 g, whereas 4 neonates (28.6%) were growth restricted (<10th percentile). 4 The frequency of growth restriction was not significantly different in fetuses with ( Ventriculomegaly (2) Encephalocele (1) Hydromyelia (1) Other (n = 2) 2-vessel cord (2) cases with nonisolated hemivertebrae were performed for 1 set of twins with a nonreassuring fetal heart rate pattern and 1 instance of type I maternal osteogenesis imperfecta. …”

“…1,3 Hemivertebrae are nonisolated in 88.5% of neonates when newborn physical features detected by a geneticist's physical examination are additionally considered. 2 The cardiovascular, urinary, skeletal, gastrointestinal, and central nervous systems are most commonly involved. [1][2][3] Importantly, these birth defects may occur as part of syndromes that may negatively affect the prognosis, such as VATER syndrome (vertebral anomalies, imperforate anus, tracheoesophageal fistula, and renal anomalies), VACTERL syndrome (VATER with cardiac and limb anomalies), Klippel-Feil syndrome, Jarcho-Levin syndrome, OEIS (omphalocele, bladder exstrophy, imperforate anus, and spine anomalies), the Potter sequence, and open spina bifida.…”

“…1,2 Despite this incidence, surprisingly few published reports have addressed the importance of prenatally detected hemivertebrae. [1][2][3] Moreover, obstetric outcomes of affected fetuses remain largely unexplored. Therefore, we performed a multicenter retrospective cohort study to evaluate associated anomalies and outcomes of fetuses with prenatally diagnosed hemivertebrae.…”

Fusionless posterior hemivertebra resection in a 2-year-old child with 16 years follow-up

“…anomaly; however, according to a recent report by Goldstein et al [1], based on prenatal ultrasound diagnosis, the incidence of hemivertebra is 0.33 out of 1,000 live born infants. The natural history of hemivertebra is well known [2][3][4][5] and if untreated, the deformity will most likely increase throughout childhood and adolescence resulting in structural changes also in the unaffected region of the spine.…”

Reference Ranges for Vertebral Body Areas of the Fetal Lumbosacral Spine on 3-Dimensional Sonography Using Volume Contrast Imaging With OmniView

“…4 Despite the relevance of diagnosing this condition prenatally, few articles published in the literature have addressed the sonographic criteria for proper diagnosis. [5][6][7] In a recent study, it was shown that most fetuses with a diagnosis of hemivertebrae have associated abnormalities that are frequently syndromes, and these affect their postnatal prognosis. 4 Hence, it is important to achieve a proper prenatal diagnosis.…”