Vertebral Body Scalloping/Widened Canal



Vertebral Body Scalloping/Widened Canal


Bryson Borg, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Normal Variant


  • Vertebral Segmentation Failure


  • Dural Dysplasia


  • Intraspinal Mass



    • Ependymoma


    • Schwannoma


    • Neurofibroma


    • Meningioma


    • Arachnoid Cyst


    • Lipoma


    • Astrocytoma


    • Dermoid and Epidermoid Tumors


Less Common



  • Congenital Skeletal Disorders



    • Achondroplasia


    • Mucopolysaccharidoses (Morquio, Hurler)


  • Diastematomyelia


  • Juvenile Idiopathic Arthritis


  • Severe, Longstanding Communicating Hydrocephalus


  • Hydrosyringomyelia


  • Acromegaly


ESSENTIAL INFORMATION


Helpful Clues for Common Diagnoses



  • Normal Variant



    • Body slightly concave on all surfaces


  • Vertebral Segmentation Failure



    • Single level cervical fusion a rather common, incidental anomaly


    • “Waisted” appearance at the fusion due to stress shielding


  • Dural Dysplasia



    • Intrinsic weakness in dura, transmitted CSF pressure causes bony remodeling


    • Seen with neurofibromatosis type 1, Marfan disease, homocystinuria, Ehlers-Danlos, and ankylosing spondylitis


  • Ependymoma



    • Enhancing intramedullary or intradural-extramedullary (lumbosacral canal) mass


  • Schwannoma



    • Extramedullary mass, typically ventral or lateral to the cord or within fibers of the cauda equina


    • Those associated with canal remodeling typically fusiform or dumbbell in shape


  • Neurofibroma



    • In this context, not reliably differentiated from schwannoma (see above)


  • Meningioma



    • Intradural-extramedullary enhancing mass, with broad dural base


  • Arachnoid Cyst



    • Circumscribed, thin-walled, nonenhancing extramedullary mass, follows CSF signal/attenuation


Helpful Clues for Less Common Diagnoses



  • Achondroplasia



    • Congenitally short, narrowed pedicles; bullet-shaped vertebral bodies with posterior scalloping






Image Gallery









Sagittal bone CT shows developmental fusion of C3 and C4 with “waisting” at the level of the fusion image.

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Vertebral Body Scalloping/Widened Canal

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