Lumbar hemivertebra in an adult treated by transpedicular osteotomy

World Neurosurg. 2012 Mar-Apr;77(3-4):592.e5-9. doi: 10.1016/j.wneu.2011.04.029. Epub 2011 Nov 7.

Abstract

Background: Hemivertebra frequently occurs in pediatric patients and is treated with vertebral excision to stop the progression of the deformity. A case of L3 hemivertebra associated with lumbar kyphoscoliosis in an adult is reported.

Case description: A 46-year-old woman presented with severe chronic back pain of 6 years' duration. Radiologic examinations showed that the L3 vertebra had a trapezoidal shape revealing a partially segmented hemivertebra.

Results: The patient underwent a two-stage corrective surgery. The first stage consisted of a transpedicular osteotomy (TPO) with posterior instrumentation from L1 to L5 and a bone graft; 1 month later, anterior interbody fusions were performed at L2-3 and L3-4 using interbody cages and bone morphogenetic protein. No postoperative complication was reported after 2 years of follow-up.

Conclusions: TPO improved clinical symptoms, corrected the spinal deformity, and reduced the lumbar kyphosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bone Plates
  • Bone Transplantation
  • Disability Evaluation
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Lordosis / congenital
  • Lordosis / diagnostic imaging
  • Lordosis / surgery
  • Low Back Pain / etiology
  • Neurosurgical Procedures / methods*
  • Osteotomy / methods*
  • Postoperative Care
  • Scoliosis / congenital
  • Scoliosis / diagnostic imaging
  • Scoliosis / surgery*
  • Spine / abnormalities*
  • Spine / diagnostic imaging
  • Spine / surgery*
  • Tomography, X-Ray Computed