Congenital Vertebral Anomalies

Julia Crim, MD

DIFFERENTIAL DIAGNOSIS

Common

Abnormalities of Segmentation
- Failure of Vertebral Formation
- Vertebral Segmentation Failure
- Partial Vertebral Duplication
- Klippel-Feil Spectrum
- Craniovertebral Junction Variants
- VACTERL Association
- Scoliosis and Kyphosis, Congenital
Acquired Vertebral Body Fusion
- DISH
- Juvenile Idiopathic Arthritis
- Spondyloarthropathy, Seronegative
- Post-Operative Change, Normal
Spinal Dysraphism
- Incomplete Fusion, Posterior Element
- Meningocele, Dorsal Spinal
- Myelomeningocele
- Lipomyelomeningocele
- Diastematomyelia
Caudal Regression Syndrome
Multiple Abnormally Shaped Vertebrae, Acquired
- Scheuermann Disease
- Sickle Cell
- Juvenile Idiopathic Arthritis
- Cushing Disease
- Osteomyelitis, Granulomatous
- Radiation of Spine in Childhood
Single Abnormally Shaped Vertebra, Acquired
- Limbus Vertebra
- Post-Traumatic Deformity
- Osteochondroma

Less Common

ESSENTIAL INFORMATION

Key Differential Diagnosis Issues

Must decide if single or multiple levels involved
Abnormalities acquired in childhood cause growth disturbance, mimic congenital anomalies
Extra-spinal abnormalities often helpful in diagnosis

Helpful Clues for Common Diagnoses

Abnormalities of segmentation may not be visible on routine radiographs
- Coned-down views, CT scan, or MR useful especially at craniocervical junction
- Always consider, especially with atypical scoliosis
  - Short curve, unbalanced, or thoracic convex left
Widened spinal canal on AP radiograph sign of dysraphism