Scalloped Vertebral Bodies

Scalloped Vertebral Bodies
Bernadette L. Koch, MD
DIFFERENTIAL DIAGNOSIS
Common
  • Vertebral Segmentation Failure
  • Spinal Dysraphism
Less Common
  • Achondroplasia
  • Mucopolysaccharidoses
  • Dural Dysplasia
Rare but Important
  • Syringomyelia
  • Intraspinal Mass
ESSENTIAL INFORMATION
Helpful Clues for Common Diagnoses
  • Vertebral Segmentation Failure
    • Single or multiple levels, widened or narrow canal ± dorsal scalloping
  • Spinal Dysraphism
    • Myelomeningocele: Open neural tube defect, wide osseous dysraphism ± diastematomyelia, syrinx, congenital or developmental kyphoscoliosis
      • ≈ 100% have Chiari 2 malformation
    • Lipomyelocele or lipomyelomeningocele: Skin covered; neural placode/lipoma complex contiguous with SQ fat through osseous dysraphic defect
    • Diastematomyelia ± fibrous, osteocartilaginous, or osseous spur, intersegmental vertebral fusion, thick filum, or tethered cord
Helpful Clues for Less Common Diagnoses
  • Achondroplasia
    • Flat or bullet-shaped vertebra + short pedicles + posterior scalloping
    • Spinal stenosis secondary to degenerative disease + congenital short pedicles
    • Lumbar hyperlordosis, thoracolumbar kyphoscoliosis
    • ± costochondral junction stenosis, rarely C1-2 instability
  • Mucopolysaccharidoses
    • Inherited lysosomal storage disorders, Hurler syndrome (MPS I-H) most common
    • Vertebral beaking, thoracolumbar gibbus ± spinal stenosis, dorsal vertebral scalloping
    • Narrow foramen magnum, short posterior C1 arch, odontoid hypoplasia
  • Dural Dysplasia
    • Patulous sac + dorsal vertebral scalloping
      • ± neurofibromas or other spinal neoplasms in neurofibromatosis type 1
      • ± arterial dissection or aneurysm in Marfan and Ehlers-Danlos syndrome
      • Osteoporosis in homocystinuria
Helpful Clues for Rare Diagnoses
  • Syringomyelia
    • ± wide canal, spinal dysraphism, Chiari 1, or neoplasm
  • Intraspinal Mass
    • Intramedullary or extramedullary mass image enlargement of canal &/or vertebral scalloping
Aug 10, 2016 | Posted by in PEDIATRICS | Comments Off on Scalloped Vertebral Bodies

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