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Insights into Imaging
Published in: Insights into Imaging 3/2018

Open Access 01-06-2018 | Pictorial Review

Malformed vertebrae: a clinical and imaging review

Authors: Apeksha Chaturvedi, Nina B. Klionsky, Umakanthan Nadarajah, Abhishek Chaturvedi, Steven P. Meyers

Published in: Insights into Imaging | Issue 3/2018

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Abstract

A variety of structural developmental anomalies affect the vertebral column. Malformed vertebrae can arise secondary to errors of vertebral formation, fusion and/or segmentation and developmental variation. Malformations can be simple with little or no clinical consequence, or complex with serious structural and neurologic implications. These anomalies can occasionally mimic acute trauma (bipartite atlas versus Jefferson fracture, butterfly vertebra versus burst fracture), or predispose the affected individual to myelopathy. Accurate imaging interpretation of vertebral malformations requires knowledge of ageappropriate normal, variant and abnormal vertebral morphology and the clinical implications of each entity. This knowledge will improve diagnostic confidence in acute situations and confounding clinical scenarios.
This review article seeks to familiarize the reader with the embryology, normal and variant anatomy of the vertebral column and the imaging appearance and clinical impact of the spectrum of vertebral malformations arising as a consequence of disordered embryological development.
Teaching points
• Some vertebral malformations predispose the affected individual to trauma or myelopathy.
• On imaging, malformed vertebrae can be indistinguishable from acute trauma.
• Abnormalities in spinal cord development may be associated and must be searched for.
• Accurate interpretation requires knowledge of normal, variant and abnormal vertebral morphology.
Appendix
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Literature
1.
Meyers SP. Differential Diagnosis in Neuroimaging-Spine: Thieme; December, 2016
2.
Trenga AP, Singla A, Feger MA, Abel MF (2016) Patterns of congenital bony spinal deformity and associated neural anomalies on X-ray and magnetic resonance imaging. J Child Orthop 10(4):343–352CrossRefPubMedPubMedCentral
3.
Klimo P Jr, Rao G, Brockmeyer D (2007) Congenital anomalies of the cervical spine. Neurosurg Clin N Am 18(3):463–478CrossRefPubMed
4.
Passias PG, Poorman GW, Jalai CM et al (2017) Incidence of congenital spinal abnormalities among pediatric patients and their association with scoliosis and systemic anomalies. J Pediatr Orthop
5.
6.
7.
Schwartz ES, Rossi A (2015) Congenital spine anomalies: the closed spinal dysraphisms. Pediatr Radiol 45(Suppl 3):S413–S419CrossRefPubMed
8.
David KM, McLachlan JC, Aiton JF et al (1998) Cartilaginous development of the human craniovertebral junction as visualised by a new three-dimensional computer reconstruction technique. J Anat 192(Pt 2):269–277CrossRefPubMedPubMedCentral
9.
Copley LA, Dormans JP (1998) Cervical spine disorders in infants and children. J Am Acad Orthop Surg 6(4):204–214CrossRefPubMed
10.
Kim HJ (2013) Cervical spine anomalies in children and adolescents. Curr Opin Pediatr 25(1):72–77CrossRefPubMed
11.
Barkovich JARJ (2012) Pediatric Neuroimaging. 5th Ed. ed. Lippincott Williams and Wilkins, Philadelphia, PA
12.
Tsou PM, Yau A, Hodgson AR (1980) Embryogenesis and prenatal development of congenital vertebral anomalies and their classification. Clin Orthop Relat Res 152:211–231
13.
Dias MS, Walker ML (1992) The embryogenesis of complex dysraphic malformations: a disorder of gastrulation? Pediatr Neurosurg 18(5–6):229–253CrossRefPubMed
14.
Singh SK, Singh RD, Sharma A (2005) Caudal regression syndrome—case report and review of literature. Pediatr Surg Int 21(7):578–581CrossRefPubMed
15.
Boulas MM (2009) Recognition of caudal regression syndrome. Adv Neonatal Care 9(2):61–69 quiz 70-1 CrossRefPubMed
16.
Rossi A, Biancheri R, Cama A, Piatelli G, Ravegnani M, Tortori-Donati P (2004) Imaging in spine and spinal cord malformations. Eur J Radiol 50(2):177–200CrossRefPubMed
17.
Pang D (1993) Sacral agenesis and caudal spinal cord malformations. Neurosurgery 32(5):755–778 discussion 78-9 CrossRefPubMed
18.
Sikandar R, Munim S (2009) Sirenomelia, the mermaid syndrome: case report and a brief review of literature. J Pak Med Assoc 59(10):721–723PubMed
19.
Johal J, Loukas M, Fisahn C, Chapman JR, Oskouian RJ, Tubbs RS (2016) Hemivertebrae: a comprehensive review of embryology, imaging, classification, and management. Childs Nerv Syst 32(11):2105–2109CrossRefPubMed
20.
Oskouian RJ Jr, Sansur CA, Shaffrey CI (2007) Congenital abnormalities of the thoracic and lumbar spine. Neurosurg Clin N Am 18(3):479–498CrossRefPubMed
21.
Tracy MR, Dormans JP, Kusumi K (2004) Klippel-Feil syndrome: clinical features and current understanding of etiology. Clin Orthop Relat Res 424:183–190CrossRef
22.
Xue X, Shen J, Zhang J et al (2014) Klippel-Feil syndrome in congenital scoliosis. Spine (Phila Pa 1976) 39(23):E1353–E1358CrossRef
23.
Hensinger RN, Lang JE, MacEwen GD (1974) Klippel-Feil syndrome; a constellation of associated anomalies. J Bone Joint Surg Am 56(6):1246–1253CrossRefPubMed
24.
Winter RB, Moe JH, Lonstein JE (1984) The incidence of Klippel-Feil syndrome in patients with congenital scoliosis and kyphosis. Spine (Phila Pa 1976) 9(4):363–366CrossRef
25.
Samartzis D, Lubicky JP, Herman J, Shen FH (2006) Faces of spine care: from advanced imaging. Severe thoracic kyphoscoliosis in a Klippel-Feil patient with complete cervical spine fusion and deformity—primum non nocere. Spine J 6(6):723–724CrossRefPubMed
26.
Vaidyanathan S, Hughes PL, Soni BM, Singh G, Sett P (2002) Klippel-Feil syndrome—the risk of cervical spinal cord injury: a case report. BMC Fam Pract 3:6CrossRefPubMedPubMedCentral
27.
O’Donnel DP, Seupaul RA (2008) Klippel-Feil syndrome. Am J Emerg Med 26(2):252 e1–252 e2
28.
Harvey EJ, Bernstein M, Desy NM, Saran N, Ouellet JA (2012) Sprengel deformity: pathogenesis and management. J Am Acad Orthop Surg 20(3):177–186CrossRefPubMed
29.
Dias MS, Li V, Landi M, Schwend R, Grabb P (1998) The embryogenesis of congenital vertebral dislocation: early embryonic buckling? Pediatr Neurosurg 29(6):281–289CrossRefPubMed
30.
Satpathy A, Sloan R, Bhoora IG (2004) Compression fracture or butterfly vertebra: diagnostic importance in a trauma setting. Ann R Coll Surg Engl 86(6):W41–W43CrossRefPubMedPubMedCentral
31.
O’Brien WT Sr, Shen P, Lee P (2015) The dens: normal development, developmental variants and anomalies, and traumatic injuries. J Clin Imaging Sci 5:38CrossRefPubMedPubMedCentral
32.
33.
Arvin B, Fournier-Gosselin MP, Fehlings MG (2010) Os odontoideum: etiology and surgical management. Neurosurgery 66(suppl_3):A22–A31CrossRef
34.
Wigh RE (1980) The thoracolumbar and lumbosacral transitional junctions. Spine (Phila Pa 1976) 5(3):215–222CrossRef
35.
Konin GP, Walz DM (2010) Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR Am J Neuroradiol 31(10):1778–1786CrossRefPubMed
36.
Elster AD (1989) Bertolotti’s syndrome revisited. Transitional vertebrae of the lumbar spine. Spine (Phila Pa 1976) 14(12):1373–1377CrossRef
37.
Hughes RJ, Saifuddin A (2004) Imaging of lumbosacral transitional vertebrae. Clin Radiol 59(11):984–991CrossRefPubMed
38.
Castellvi AE, Goldstein LA, Chan DP (1984) Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine (Phila Pa 1976) 9(5):493–495CrossRef
39.
Singh K, Samartzis D, Vaccaro AR et al (2005) Congenital lumbar spinal stenosis: a prospective, control-matched, cohort radiographic analysis. Spine J : Off J N Am Spine Soc 5(6):615–622CrossRef
40.
Cowley P (2016) Neuroimaging of spinal canal stenosis. Magn Reson Imaging Clin N Am 24(3):523–539CrossRefPubMed
41.
Abduljabbar FH, Rossel F, Nooh A, Jarzem P (2015) Misdiagnosing absent pedicle of cervical spine in the acute trauma setting. Orthop Rev (Pavia) 7(3):5889CrossRef
42.
Ferracci FX, Dudoit T, Gilard V, Perez A, Lucas F (2017) Cervical pedicular agenesis: case report and a review of the literature. Neurochirurgie 63(4):323–326CrossRefPubMed
Metadata
Title
Malformed vertebrae: a clinical and imaging review
Authors
Apeksha Chaturvedi
Nina B. Klionsky
Umakanthan Nadarajah
Abhishek Chaturvedi
Steven P. Meyers
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 3/2018
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1007/s13244-018-0598-1

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