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  • Title: Scoliosis secondary to a hemivertebra: seven patients with gradual improvement without treatment.
    Author: Winter RB, Lonstein JE.
    Journal: Spine (Phila Pa 1976); 2010 Jan 15; 35(2):E49-52. PubMed ID: 20081501.
    Abstract:
    STUDY DESIGN: Retrospective case series. OBJECTIVE: To make clinicians aware of this unusual natural history. SUMMARY OF BACKGROUND DATA: Nonprogressive and progressive scolioses due to hemivertebrae have been abundantly documented in the literature. There has been no article describing spontaneous improvement. Two case reports have been described elsewhere in a general article on natural history. METHODS: From a previous review of 1250 patients with congenital spine deformity of all types, 7 patients were identified with spontaneous improvement of their scoliosis due to a hemivertebra during growth. RESULTS: The mean curve at start of observation was 31 degrees (range: 24 degrees -43 degrees), and at the end of observation was 19 degrees (range: 10 degrees -30 degrees). Six of the curves were at the thoracolumbar region (T11-L2), and the other at T1. The average duration of follow-up was 9 years. CONCLUSION: Spontaneous curve improvement is rare, but possible. In view of the difficulty of prediction for curves due to a hemivertebra, careful observation with careful curve measurement is recommended. Inappropriate early, aggressive surgery should be avoided.
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