Selective Resection of Two Ipsilateral Supernumerary Hemivertebrae in a Child With Congenital Scoliosis: A Case Report

Management of congenital scoliosis with multiple hemivertebrae remains challenging.Clinical decisions should take into consideration various factors, such as the location, morphology, and growth potential of each hemivertebra, as well as overall spinal balance.Early surgery is typically recommended to halt the progression of deformity.Strategies include resection of the hemivertebra using a posterior or combined anterior-posterior approach, followed by fusion.This report describes a case of a six-year-old child with three hemivertebrae on the same side, leading to an unbalanced spine that was progressive in nature.Preoperative planning showed three right-sided supernumerary hemivertebrae at the T6, T12, and L2 levels (supernumerary cervical, thoracic, and lumbar segments).The proximal thoracic curve due to the T6 hemivertebra was not progressive, but the T12 and L2 hemivertebrae produced thoracolumbar/lumbar curves and typically progressed over time.We planned selective surgical resection of the T12 and L2 vertebrae via a posterior approach and achieved a 93% correction of the major thoracolumbar/lumbar Cobb angle (57° to 4°).There was no neurological deterioration, and the child fared well after surgery.We believe this case will help us with clinical decisionmaking and surgical planning for similar cases.