Dr. Khalid Sulaiman, M.D., FRCS,
Dr. J. Richard Bowen MD.
Alfred I. duPont Institute
1600 Rockland Road
Wilmington, Delaware 19803
ABSTRACT: A study of congenital scoliosis was undertaken to assess the rate of progress of the curves in patients with hemivertebrae. Only those patients with two hemivertebrae or less and without any other anomaly likely to affect the scoliotic curve were studied. Records of all the patients who attended the Alfred I. duPont Institute from 1981 till 1995 with the diagnosis of congenital scoliosis were reviewed. 217 records were studied to reveal 26 patients with hemivertebrae. All patients with congenital scoliosis and associated neuromuscular disease, chromosomal abnormalities, and those whose radiographs were not available for review were excluded. Of the 26 patients the distribution of the anomalies was 1 cervical; 5 upper thoracic (T1-T6); 15 lower thoracic (T7-T12), 4 lumbar and 1 sacral. 19 patients had serial radiographs that allowed evaluation of the changes. In 17 prior to surgery the rate of progression was on the average 3 degrees (range 2 to 5) per year. In two patients there were episodes of rapid progression at more than 10 degrees per year. Both these patients were subsequently found to have an intraspinal pathology. In conclusion Scoliosis associated with hemivertebrae progress at an rate of 2 to 5 degrees per year but in those that rapidly change an intraspinal pathology must be considered.
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