Spinal Anomalies Flashcards
(25 cards)
Hahn Clefts
Vascular Channels
Appears as a horizontal lucency within the VB extending to the posterior VB cortex
Nuclear Impression/Notochordal Remnant
Smooth and wide impression on the inferior endplate.
Apex of curve is typically placed posterior
Look for Cupid’s Bow sign on AP Views
Asymptomatic
Schmorl’s Node
Abrupt (like a pencil eraser) sclerotic impression on either the superior or inferior endplate
Asymptomatic
Anterior Limbus Bone
Small, well corticated bony ossicle at the anterior superior endplate
Asymptomatic
Posterior Limbus Bone
Small, well corticated bony ossicle at the posterior inferior endplate or posterior superior endplate
Symptomatic, contraindication to SMT
Spina Bifida Occulta/Spondyloschisis Defect
Failure of neural arch fusion and development of SP.
Cervical SP: lack of spinolaminar junction line
Most commonly seen at L5/S1 and transitional zones
Asymptomatic
Knife Clasp Deformity
SBO at S1 with enlarged L5 SP
Possibly symptomatic with extension
Transitional Lumbosacral Vertebra
Spatulated TVP ( greater than or equal to 19 mm) Hypoplastic disc Possible pseudoarticulation with sacral ala
Pedicle Agenesis
Congenital absence of a pedicle
Look for sclerosis of the contralateral pedicle
Facet Tropism
Facets are in different planes
Most commonly seen at L5S1
Congenital Block Vertebra
Failure of somite segmentation Contraindication to SMT Key characteristics: Anterior VB fusion Wasp Waist Hypoplastic Disc Possible posterior element fusion
Butterfly Vertebra
Angled end plates
increased interpediculate distance
enlarged pedicles
Hemivertebra
Lateral: Most common, cause of scoliosis
Dorsal: Greater kyphotic curve, symptomatic, ortho consult
Ventral: greater lordotic curve
“incarcerated”: fused to adjacent VB
Klippel-Feil Syndrome
Clinical Features:
Short Neck
Low posterior hair line
Decreased cervical ROM
Multiple congenital vertebral anomalies
Sprengel’s deformity association
Sprengel’s Deformity
Inferior rotation of scapula and scapular unleveling (2-10 cm)
Possible omovertebral bone: accessory bony ossicle from spine to superior border of scapula
Os Odontoidium
Diagnosed after age 7Y Rounded Anterior tubercle of C1 Free floating bony ossicle above C2 body No ADI Contraindication to SMT DDX: Dens agenesis, dens hypoplasia
Ossiculum Terminale
Diagnosed after age 12 Y accessory ossicle (triangular) above tip of dens
Agenesis of C1 Posterior Arch
Missing posterior arch of C1 C2 megaspinous Wide ADI Anterior tubercle (C1) hypertrophy Contraindication to SMT
Posterior Ponticle
Forms an arcuate foramen
Associated with headaches
Contraindication to SMT with headache
Third Condyle
Accessory ossicle anterior and inferior to the foramen magnum
Possible pseudoarticulation with anterior tubercle (C1) and tip of Dens
Paramastoid/Epitransverse Process
Articulation between paracondylar area with C1 TVP
Contraindication to SMT at C0C1
Occipitalization
Block vertebra between C0C1 Clinical symptoms: Headaches Decreased ROM Long Neural tract signs
Associated with:
Klippel-Feil Syndrome
Basilar Impression
Contraindication to SMT
Nuchal Bones
Sesmoid bones within nuchal ligament
Cervical Rib
hypoplastic rib on cervical TVP
