The objective of this review is to discuss the indications, surgical technique, and potential complications of thoracic hemivertebra excision in the pediatric population. Thoracic hemivertebra produce a congenital scoliosis or kyphoscoliosis that may progress and require surgical intervention. Patients may require either separate anterior and posterior approaches for hemivertebra excision, or more recently, a posterior-only approach has been developed, which is our preferred method. A posterior-only approach is accomplished with a unilateral costotransversectomy, which allows complete hemivertebra excision as well as reconstruction of the anterior as well as posterior column. Preoperative preparation, intraoperative pearls, and pitfalls and postoperative care will be discussed for this surgical procedure.
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