<![CDATA[Introduction: The vertebral column functions to support the body and protect the spinal cord. Hemivertebra is a congenital disorder due to the failure of the formation of part of the vertebral corpus and often causes scoliosis. Scoliosis due to the hemivertebra is progressive, can cause spinal imbalance and severe deformity. The diagnosis can be established through prenatal ultrasound, X-rays, CT scans, and MRIs. X-rays are generally used as an initial examination because they are easily accessible, but they have limitations in assessing complex deformities. CT scans with three-dimensional reconstruction provide a detailed picture of vertebral structure for preoperative planning, while MRI allows for a comprehensive evaluation of neural axis abnormalities without radiation exposure. Case Report: A 14-year-old boy came to dr. Slamet Garut Hospital with complaints of asymmetrical back accompanied by a growing lump and right back pain since the last three years. Patients also complain of getting tired easily and sweating quickly during activities. The history of the disease shows pulmonary tuberculosis at the age of six months which has been treated completely. History of growth and development is obtained with delays in motor and speech development. MSCT-scan thoracoumbal Th1 to os sacrum with contrast showed congenital severe kyphoscoliosis due to the fully segmented type hemivertebra in Th12, with no peccule and left costa 12, as well as suspicion of narrowing of the posterior spinal canal. Conclusions: The patient was diagnosed with congenital severe kyphoscoliosis due to hemivertebra fully segmented Th12 accompanied by pedicle and costa abnormalities. 3D/MSCT CT and MRI are more accurate than X-rays in assessing complex deformities and nerve structures. The definitive management recommended is hemivertebrectomy to prevent the progression of deformity.]]>
