Natural History of Bilateral Congenital Absence of the L4 Pedicles

Case A 5-month-old girl was diagnosed with congenital bilateral absence of the L4 pedicles and an absent right kidney. She developed a right thoracic scoliosis at age 3 that was treated with a brace. At her most recent follow-up at age 16, she was skeletally mature and had a residual 20° right thoracic scoliosis. She was pain-free, had a normal neurological examination, and was fully active. Conclusion This case presents a long-term follow-up of a patient with congenital bilateral absence of L4 pedicles. She developed scoliosis that was successfully treated with bracing. No other significant issues developed over 15 years of follow-up.