![]() At each visit, the current radiograph should be compared with both the previous radiograph and the original radiograph so that an accurate assessment of curve progression can be determined. HEMIVERTEBRAE RAD IOGRAPH SERIALThe degree of curvature is established by using the standard Cobb method.įollow-up radiographic assessment should be performed with serial standing radiographs at 3- to 6-month intervals, depending on the age of the child and the degree of curvature. A high-quality magnetic resonance image (MRI) or computed tomography scan with coronal and sagittal reformats can assist in this regard.Ĭurve description is based on the direction in which the apex points, the region of the spine in which the primary curve or curves occur, the location of compensatory curves, and sagittal deformity and sagittal balance. After the type of anomaly on the anteroposterior radiograph has been identified, the number of viable growth plates adjacent to the anomalous vertebrae should be determined to assess the potential for growth imbalance and progressive curvature. A coned-down radiograph is helpful in defining spinal anomalies. A posterolateral quadrant or corner hemivertebra, resulting in kyphoscoliosis, can be difficult to detect prior to the occurrence of significant deformity. The lateral radiograph should be examined carefully for the presence of concomitant kyphosis or lordosis. High-quality standing or sitting upright (for nonambulators) posteroanterior and lateral radiographs on a 14 × 36 inch film should be obtained. These radiographs are necessary to identify the type, location, and magnitude of curvature. Spinal radiographs should be performed in all patients with suspected congenital scoliosis. Pelvic obliquity may be seen with rigid lumbar or lumbosacral curves. In some cases, the rib deformity will be minimal despite significant scoliosis, owing to a lack of rotational deformity. A forward-bending test is done to evaluate for associated rib deformity. The shoulder is elevated on the side of the curve convexity, and the head is often tilted toward the concavity. Shoulder, scapula, and waist asymmetry and torso decompensation are often noted. The spine is evaluated with the patient in a standing position. Subtle neurologic abnormality may be noted by the presence of asymmetric calf and/or thigh circumference, asymmetric abdominal reflex, cavus foot, curled toes, and/or a mild limp. Pathologic reflexes such as ankle clonus and Babinski signs are assessed. A thorough neurologic evaluation, including motor, sensory, and reflex examination, should be done. Gait is evaluated to rule out neurologic or lower-extremity abnormalities. HEMIVERTEBRAE RAD IOGRAPH SKINMidline skin abnormalities such as a dimple, nevus, hairy patch, sinus tract, or lipoma might indicate the presence of an intraspinal anomaly. Physical examination should include an assessment of general appearance to observe for facial and trunk abnormalities or limb deficiency. Complete systemic reviews, including those of the genitourinary and cardiopulmonary systems, should be performed. A thorough history should be taken to identify prenatal drug exposure, prenatal and postnatal development, past medical history, ambulatory status and balance, and neurologic development. The evaluation of the patient with congenital scoliosis must include an assessment for associated anomalies. RAZI, in Surgical Management of Spinal Deformities, 2009 PATIENT EVALUATION The prognosis can be variable dependent on the type of segmentation anomaly, from being progressive to a non-progressive deformity. The strongest negative impact is when a hemivertebra occurs at the lumbosacral level. Usually directly outlines the bony anomaly and is often seen as a wedge-shaped vertebral body. Radiographic features Antenatal ultrasoundĪ hemivertebra may be seen as an asymmetrical vertebral body on sagittal or coronal scanning, while on axial scanning, a focal defect may be seen on either side of the vertebral column. ventral hemivertebra (extremely rare): results in lordosis.lateral hemivertebra: classically results in scoliosis.dorsal hemivertebra: classically results in kyphosis.joined by pedicles to levels above and below.connected to) either level above or below semi segmental: half segment is fused with vertebra above or below with no intervening intervertebral disc.not attached to either vertebra above or below.Recognized associations are many and include:Ī hemivertebra can be classified according to many types which include: Attachment ![]() It falls under the spectrum of segmentation anomalies and can involve one or multiple levels.Ī hemivertebra acts as a wedge within the vertebral column, resulting in curvature away from the side on which it is present. ![]() It is a common cause of congenital scoliosis. Hemivertebra is a type of vertebral anomaly and results from a lack of formation of one half of a vertebral body. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |