ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Imaging features of hemimetameric shift in children: proposal of a new classification.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo analyze the imaging findings of hemimetameric shift (HMMS) in children and propose a new classification system.
methodsThe clinical data and imaging studies of 85 HMMS patients aged 2 to 14 years were retrospectively reviewed. HMMS was classified as follows: type 1, two hemivertebrae (HV); type 2, three HV; type 3, four or more HV; and type 4, two or more HV and multiple spinal and/or costal anomalies. Inter- and intraobserver reliability of the classification system were evaluated using Fleiss' kappa coefficient. Imaging features of HMMS were analyzed using whole-spine standing radiographs, computed tomography and magnetic resonance imaging.
resultsHMMS was classified as type 1 in 54 patients, type 2 in 16, type 3 in eight, and type 4 in seven. The overall kappa value for the reliability study was 0.796, indicating that the classification system is simple and consistent. The cranial and caudal compensatory curves, coronal balance, thoracic kyphosis, and lumbar lordosis did not significantly differ between type 1 patients and patients with types 2-4 HMMS. Thoracolumbar kyphosis was significantly greater in patients with types 2-4. Discordant HMMS was found in 27 patients (31.8%). Its prevalence was significantly higher in patients with types 3 and 4 HMMS. Associated abnormalities were identified in 28 patients (32.9%). Their prevalence was significantly higher in patients with types 2-4 HMMS.
conclusionsOur proposed classification system is reliable and provides clear descriptions for various types of HMMS. Treatment of HMMS should be individualized because the clinical features vary among the different types.
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