Upgrade to remove ads
congenital anomalies of the spine
Terms in this set (18)
The bony vertebral column and the spinal cord are the same length until the 3rd month of fetal life. After that the rate of growth of the spine accelerates so that the conus medullaris ends up at lower border of the second lumbar vertebra by birth
symptoms- progressive neurologic deficits in the lower extremities. Child fails to walk normally, or starts normally then develops a gait disturbance. Physical Findings- congenital deformities of one or both lower extremities. Muscle weakness, atrophy or even paralysis of the thigh and calf muscles is seen. Urinary incontinence and poor bowel control develop. Skin ulcerations on the feet are common. Unilateral calf atrophy or club foot should be a strong indicator. Symptom onset may rarely be delayed until late in adult life.
A fusiform widening of th spinal canal is seen roentgenographically. The midline spicule may be osseous or cartilageous or even fibrous tissue. The sagittal diameter of the vertebral body is often narrowed as well. Treatment- surgical repair
Anterior vertebral agenesis
Treatment- surgical reconiguration of the spine up to age 25 at the latest. After age 25, too bad; they're stuck with it.
Occult Spina Bifida
Occult means hidden. This is not the more generally known spina bifida cystica with its spinal cord and cauda equina defects. This is another potential destabilizer of the lower back. If the spinous process is not there for the supraspinous ligament to attach to, then the ligament itself may be congenitally absent at that segment
This term means esentially cleft spinal cord. The cord is split in two by a mass of fibrous tissue or bone attached to the vertebral body anteriorly, and to the lamina or dura posteriorly. May occur at one of several spinal segments. Most common in the lumbar spine, but has been reported a high as the T3 level.
Low Intercrestal Line-1
Patient at risk for degenerative disc diseasae at L5/S1. Intercrestal Line passes through the body of L5. Short transverse process on L5. No transitional vertebra.
Low Intercrestal Line-2
Patient at risk for degenerative disc disease at L4/L5. Intercrestal line passes through the upper half of L4. Long transverse process on L5. Transitional Lumbosacral Segment
Low Intercrestal Line-3
Treatment is usually- aggressive exercise strengthening the supporting lumbar musculature. OMT to keep thoracic and upper lumbar motion unrestricted, as well as the hips. Premature degenerative disc disease is the consequence. Premature means as young as age sixteen
Treatment- Exercise- strengthen the supporting musculature, especially the lateral abdominal wall [abdominal obliques]. Prolotherapy- if hypermobility develops. Surgical fusion if all else fails
Transitional Lumbosacral Segment
Also called batwing vertebra. Treatment- OMT- These are mobile segments and may create pain simply due to somatic dysfunction. Traction- separate pseudoarthrosis, may provide temporary relief. Injection of corticosteroids into pseudoarthrosis. Prolotherapy, Neuronolysis
Low Intercrestal Line
In males it crosses the lumbar spine above the inferior end plate of L4. In women it crosses the lumbar spine above the mid body of L5. If the sacrum sits high between the ilia, it destabilizes the lumbar spine.
Multiple Musculo-Skeletal Anomalies
Achondroplasia, Ehlers-Danlos syndrome, Marfan syndrome, Morquio disease- Mucopolysaccharidosis Type IV, osteogenesis imperfecta, osteopetrosis, fibrodysplasia- myositis ossificans progressiva
Klippel Feil syndrome-1
fused ribs and other thoracic anomalies are present in one third of patients. Other anomalies may be more detrimental to the patients health than the vertebral anomalies. One must view this condition as the tip of the iceberg and search for other more serious anomalies
Klippel Feil syndrome-2
work up should include flexion and extension cervical spine films to search for instability. With multiple fused segments, all vertebral motion may be occurring at only one or two motion segments
Klippel Feil syndrome-3
Treatment is largely surgical when the presence of instability, or gross deformity is involved.If the spine is stable and minimally deformed, although range of motion may be limited, no treatment is indicated.
Klippel Feil syndrome-4
Multiple Cervical Vertebral Anomalies [fusions], Pterygium colli [webbed neck] with low hairline. Very limited range of motion. Hemivertebrae are common. Failure of segmentation anomaly occurring during the 3rd to 8th week of fetal development. Commonly accompanied by Sprengel Deformity- high riding scapula. Many other occult defects exist in genitourinary, vascular, cardiac and pulmonary systems. There is often hearing loss
Swan Neck deformity, transitional cranio-cervical segment, cervical ribs [transitional cervico-thoracic segment], klippel feil syndrome, syringomyelia, torticolis
THIS SET IS OFTEN IN FOLDERS WITH...
Principles of Thrust Technique
Differential Diagnosis of Neck Pain
OMM: Anterior Chapman's Points
YOU MIGHT ALSO LIKE...
CCE 3 Final: Chest Wall Problems 
Rheum- 2 ( Chaz's Cards with edits )
Down's Syndrome and Other Genetic Disorders
OTHER SETS BY THIS CREATOR
OTHER QUIZLET SETS
Bible sem 2
Act 5 Scene 3 Quotes (Who said it, what they mean/…