What factors are used to prognosticate the rate of progression and ultimate deformity due to a congenital spinal anomaly

1. The anatomic type helps determine the risk and rate of progression.

2. The location of the defect affects spinal balance and difficulty of treatment. A hemivertebra located at the lumbosacral junction causes far more spinal imbalance than one located at the mid-thoracic level. In addition, a hemivertebra at the cervicothoracic junction is more difficult to treat surgically due to limited approach options, and timing of intervention may be altered based on this consideration.

3. The age of the patient determines the risk of progression. Spinal deformities are more likely to progress during times of rapid growth, such as the first 2 years of life and during the adolescent growth spurt.

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