Six patients with lumbosacral hemivertebrae were treated by one-stage anterior and posterior excision of the hemivertebrae. Long-term follow-up is reported. Overall, correction of the lumbosacral curve was 46%, including one case of pseudarthrosis and subsequent loss of correction. More importantly, truncal imbalance was restored unless other congenital thoracic anomalies were present. New methods of calculating rib cage shift on the pelvis as well as vertebral column displacement from the sagittal plane are presented.