A 6-year-old child is brought with progressive back deformity. X-ray shows hemivertebra at T8 producing a structural scoliosis. The parent asks about prognosis. Which of the following statements is most accurate?
- A A block vertebra (failure of segmentation) has the same poor prognosis as a hemivertebra
- B Congenital scoliosis due to a fully segmented hemivertebra progresses rapidly and often requires early surgical intervention ✓
- C Congenital scoliosis rarely needs surgery as bracing alone corrects the deformity
- D Hemivertebra causes purely cosmetic deformity without risk of cord compromise
Correct answer: B. Congenital scoliosis due to a fully segmented hemivertebra progresses rapidly and often requires early surgical intervention
Explanation
A fully segmented hemivertebra has growth plates on both sides and is the most growth-disturbing type, producing progressive scoliosis that worsens rapidly during growth spurts. It often requires hemivertebrectomy or convex hemiepiphysiodesis in young children to prevent severe deformity. Block vertebrae (failure of segmentation) have the best prognosis as they cause minimal progression. Bracing is ineffective for structural congenital scoliosis.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.