Pediatric cervical Hemivertebrae – A Rare Case Presentation
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Hemi vertebrae are very rarely seen at a cervical level which results in kyphotic deformity without coronal tilt. Vertebral formation defects have been the basis of congenital kyphoscoliosis deformity in the pediatric age group. Cervical spine kyphosis more than 10° along with kinking of cord at a single level results in neurodeficits which require urgent management on the lines of decompression, realignment, and bony fusion to prevent recurrence and failure and to achieve superior outcomes. Congenital subaxial cervical spine instability in very young or small-for-age children is uncommon and typically arises from trauma or skeletal dysplasia.

A 3-year-old male patient presented with complain of progressive bilateral upper and lower limb weakness and progressive deformity of the cervical spine which increased in the past 2 months. The patient earlier used to walk with support. However, for 2 months, there was progressive decrease in motor function. Cervical X-rays with lateral projection were done which showed C3 hemivertebrae resulting in significant kyphosis of the cervical spine posterior facet subluxation with increased interspinous widening.

C3 hemivertebrectomy and stabilization from C2 to C4 with fibular strut grafting and anterior cervical plating were done under neuromonitoring guidance. The neurologic symptoms of the patient were markedly improved after surgery.

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