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Shimokawa N, Takahashi I, Iizuka H. Spinal malformation - A biochemical analysis using congenital kyphosis rats. J Cell Biochem 2022; 123:501-505. [PMID: 34978108 DOI: 10.1002/jcb.30206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/25/2021] [Accepted: 12/17/2021] [Indexed: 11/06/2022]
Abstract
Spinal kyphosis involves the vertebrae curving excessively backward, beyond their physiological curvature. Although the normal structure of the spinal vertebrae is extremely important for maintaining posture, the normal function of the thoracic and abdominal organs, and cosmetics, our knowledge concerning the pathogenesis of this disease is lacking. Furthermore, the responsible gene has not yet been identified. In this short review, we summarize the current state of kyphosis research and introduce the molecular and cellular mechanisms associated with the pathogenesis of this disease, based on findings obtained using rats that develop kyphosis.
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Affiliation(s)
- Noriaki Shimokawa
- Department of Nutrition, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan.,Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Itsuki Takahashi
- Department of Nutrition, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan
| | - Haku Iizuka
- Division of Orthopedic Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
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Butterfield S, Garcia-Gonzalez B, Driver CJ, Rusbridge C. Limited dorsal myeloschisis in three cats: a distinctive form of neural tube defect. JFMS Open Rep 2020; 6:2055116920924307. [PMID: 32655875 PMCID: PMC7328493 DOI: 10.1177/2055116920924307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Case series summary The aim of this case series was to describe the clinical presentation,
imaging findings and histopathology of three cats with limited dorsal
myeloschisis (LDM). The history, examination and MRI sequences were reviewed
in three cases presented to a single referral hospital. The surgery report
and histopathology were described in two cases. All cats were young (10
weeks old, 5 months old, 4 years old), presenting with varying degrees of
progressive paraparesis. All had a midline skin defect overlying the spinal
column that was either sunken or saccular, containing fluid thought to be
cerebrospinal fluid. MRI sequences demonstrated tissue extending from the
dura through an overlying bifid spinous process and attached to the dermis,
with associated spinal cord tethering, atrophy and syringomyelia. Lesions
were located at L2–L3, T8–T9 and L4. Histopathology described a fibroneural
stalk with a glio-ependymal lining, surrounded by glial nests and nerve
fibres. The youngest and most severely affected was euthanased, while the
other two underwent surgery. Both regained independent ambulation with
persistent paraparesis; however, one required ongoing management of urinary
incontinence. Relevance and novel information LDM is a primary neural tube defect that may result in neurological deficits,
including bladder dysfunction, and is characterised by a fibroneural stalk
between the dermis and the spinal cord. Distinct MRI features, such as a
visible intrathecal tract, dorsally tethered cord and syringomyelia, help
distinguish this condition from the clinically similar dermoid sinus. The
presence of progressive neurological signs, with a palpable midline defect
overlying the affected spinal cord segment, may raise suspicion for this
clinical entity in veterinary patients.
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Affiliation(s)
| | | | - Colin J Driver
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, UK
| | - Clare Rusbridge
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, UK.,School of Veterinary Medicine, Faculty of Health & Medical Sciences, Vet School Main Building (VSM), University of Surrey, Guildford, UK
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Abstract
STUDY DESIGN Systematic review (Level 4). OBJECTIVE To summarize the demographics, clinical presentations, and conditions associated with butterfly vertebrae. METHODS A systematic search was performed of multiple databases. A total of 279 articles were identified for screening. Case series or case reports of butterfly vertebrae with adequate clinical detail were complied. RESULTS Eighty-two total articles (109 patients) were selected for final inclusion. Sixty-one percent of patients presented with a single butterfly vertebra, while 39% were multiple. The most common location for butterfly vertebrae was T1. Fifty-six percent of cases were associated with a syndrome, the most common being spondylocostal dysostosis. The presence of multiple butterfly vertebra was strongly associated with a syndrome or additional anomalies (P < .001). Overall, the most common presenting complaint was low back pain. Seventy percent of patients had associated spinal disease. Other organ systems affected included musculoskeletal (43%), craniofacial (30%), neurologic (27%), cardiovascular (24%), genitourinary (23%), gastrointestinal (22%), laboratory abnormality (16%), and endocrine (9%). CONCLUSIONS This study is the largest collection of butterfly vertebrae cases to date. Butterfly vertebrae are associated with spinal deformity and multiple butterfly vertebrae may indicate a syndromic illness. Low back pain or disc herniation may occur with lumbar butterfly vertebrae however the etiology of this phenomena has not been rigorously explained. Many diseases and syndromes are associated with butterfly vertebrae.
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Affiliation(s)
- Yoshihiro Katsuura
- University of Tennessee College of Medicine Chattanooga, Chattanooga, TN,
USA,Yoshihiro Katsuura, 975 East Third Street, Hospital
Box 260, Chattanooga, TN 37403, USA.
| | - Han Jo Kim
- Hospital for Special Surgery, New York, NY, USA,New York–Presbyterian Hospital, New York, NY, USA,Weill Cornell Medical College, New York, NY, USA
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De Decker S, Packer RMA, Cappello R, Harcourt-Brown TR, Rohdin C, Gomes SA, Bergknut N, Shaw TA, Lowrie M, Gutierrez-Quintana R. Comparison of signalment and computed tomography findings in French Bulldogs, Pugs, and English Bulldogs with and without clinical signs associated with thoracic hemivertebra. J Vet Intern Med 2019; 33:2151-2159. [PMID: 31407402 PMCID: PMC6766535 DOI: 10.1111/jvim.15556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although thoracic hemivertebra can cause neurological signs, they occur commonly in neurologically normal dogs. OBJECTIVES To evaluate whether computed tomography (CT) findings and factors associated with signalment can be used to differentiate between dogs with and without neurological signs associated with hemivertebra. ANIMALS One hundred sixty dogs with ≥1 hemivertebrae were retrospectively studied. This group consisted of 40 dogs with clinical signs caused by hemivertebra and 40 French Bulldogs, 40 Pugs, and 40 English Bulldogs that underwent CT for reasons unrelated to neurological disease. METHODS All dogs underwent CT and affected dogs also underwent magnetic resonance imaging. All CT studies were randomly evaluated by an observer blinded to signalment and clinical status. The following variables were evaluated: presence, number, location, and subtype of hemivertebra; presence of vertebral subluxation; severity of vertebral canal stenosis; presence, location, and severity of kyphosis, and number of vertebrae involved in the kyphotic segment. Statistical modeling was performed to identify factors associated with clinical status. RESULTS Pug breed (odds ration [OR], 10.8; P = .01), more severe kyphosis (OR, 1.1 per grade increase; P < .001), fewer instead of more observed hemivertebrae (OR, 0.8; P = 0.03), and ventrolateral hypoplasia hemivertebra subtype (OR, 4.0; P = .011) were associated with higher likelihood of neurological disease. A Cobb angle of 34.5 degrees corresponded with the highest combined sensitivity and specificity to differentiate between clinically affected and unaffected dogs. CONCLUSIONS AND CLINICAL IMPORTANCE The variables identified could aid in differentiating between clinically relevant and irrelevant hemivertebra in small breed brachycephalic dogs.
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Affiliation(s)
- Steven De Decker
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - Rowena M A Packer
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | | | - Tom R Harcourt-Brown
- School of Veterinary Sciences, University of Bristol, North Somerset, United Kingdom
| | - Cecilia Rohdin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Anicura, Albano Small Animal Hospital, Danderyd, Sweden
| | | | - Niklas Bergknut
- North Downs Specialist Referrals, Bletchingley, United Kingdom
| | - Tom A Shaw
- School of Veterinary Sciences, University of Bristol, North Somerset, United Kingdom
| | - Mark Lowrie
- Dovecote Veterinary Hospital, Derby, United Kingdom
| | - Rodrigo Gutierrez-Quintana
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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De Decker S, Watts V, Neilson DM. Dynamic Lumbosacral Magnetic Resonance Imaging in a Dog with Tethered Cord Syndrome with a Tight Filum Terminale. Front Vet Sci 2017; 4:134. [PMID: 28868301 PMCID: PMC5563312 DOI: 10.3389/fvets.2017.00134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 08/03/2017] [Indexed: 11/13/2022] Open
Abstract
A 1-year and 11-month- old English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness and urinary incontinence. Neurological examination was suggestive of a lesion localized to the L4–S3 spinal cord segments. No abnormalities were seen on magnetic resonance imaging (MRI) performed in the dog in dorsal recumbency and the hips in a neutral position and the conus medullaris ended halfway the vertebral body of L7. An MRI of the hips in extended and flexed positions demonstrated minimal displacement of the conus medullaris in the cranial and caudal directions, respectively. Similar to the images in neutral position, the conus medullaris ended halfway the vertebral body of L7 in both the extended and flexed positions. In comparison, an MRI of the hips in neutral, extended, and flexed positions performed in another English Cocker Spaniel revealed obvious cranial displacement of the conus medullaris with the hips in extension and caudal displacement with hips in flexion. A standard dorsal lumbosacral laminectomy was performed. Visual inspection of the vertebral canal revealed excessive caudal traction on the conus medullaris. After sectioning the distal aspect of the filum terminale, the conus medullaris regained a more cranial position. A neurological examination 4 weeks after surgery revealed clinical improvement. Neurological examinations at 2, 4, 7, and 12 months after surgery did not reveal any abnormalities, and the dog was considered to be clinically normal. Tethered cord syndrome with a tight filum terminale is a very rare congenital anomaly and is characterized by an abnormally short and inelastic filum terminale. Therefore, this disorder is associated with abnormal caudal traction on the spinal cord and decreased physiological craniocaudal movements of the neural structures within the vertebral canal. Although further studies are necessary to evaluate and quantify physiological craniocaudal movement of the spinal cord and conus medullaris in neurologically normal dogs, the results of this report suggest further exploration of dynamic MRI to demonstrate decreased craniocaudal displacement of the conus medullaris in dogs with tethered cord syndrome with a tight filum terminale.
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Affiliation(s)
- Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - Vicky Watts
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - David M Neilson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
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Kaissi AA, van Egmond-Fröhlich A, Ryabykh S, Ochirov P, Kenis V, Hofstaetter JG, Grill F, Ganger R, Kircher SG. Spine malformation complex in 3 diverse syndromic entities: Case reports. Medicine (Baltimore) 2016; 95:e5505. [PMID: 27977582 PMCID: PMC5268028 DOI: 10.1097/md.0000000000005505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Clinical and radiographic phenotypic characterizations were the base line tool of diagnosis in 3 syndromic disorders in which congenital cervico-thoracic kyphosis was the major deformity. PATIENTS CONCERNS Directing maximal care toward the radiographic analysis is not only the axial malformation but also toward the appendicular abnormalities was our main concern. We fully documented the diversity of the spine phenotypic malformation complex via the clinical and radiographic phenotypes. DIAGNOSES We established the diagnosis via phenotypic/genotypic confirmation in 3 diverse syndromic entities namely acampomelic campomelic dysplasia, Larsen syndrome and Morquio syndrome type A (mucopolysaccharidosis type IV A). INTERVENTIONS Surgical interventions have been carried out in the Larsen syndrome and Morquio syndrome type A, resepectively. OUTCOMES The earliest the diagnosis is, the better the results are. The necessity to diagnose children in their first year of life has many folds, firstly the management would be in favor of the child's growth and development and secondly, the prognosis could be clearer to the family and the medical staff as well. Our current paper is to sensitize paediatricians, physicians and orthopedic surgeons regarding the necessity to detect the aetiological understanding in every child who manifests a constellation of malformation complex. LESONS Scoliosis and kyphosis/kyphoscoliosis are not a diagnosis in themselves. Such deformities are mostly a symptom complex correlated to dozens of types of syndromic associations. The rate curve progression and the final severity of congenital spine tilting are related to 3 factors: (a) the type of vertebral malformation present, (b) the patient's phenotype, and
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Affiliation(s)
- Ali Al Kaissi
- Ludwig Boltzmann Institute of Osteology, the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital
- Orthopaedic Hospital of Speising, Paediatric Department
| | | | - Sergey Ryabykh
- Axial Skeleton and Neurosurgery Department, Restorative Traumatology and Orthopaedics, Ilizarov Center, Kurgan, Russia
| | - Polina Ochirov
- Axial Skeleton and Neurosurgery Department, Restorative Traumatology and Orthopaedics, Ilizarov Center, Kurgan, Russia
| | - Vladimir Kenis
- Pediatric Orthopedic Institute n.a. H. Turner, Department of Foot and Ankle Surgery, Neuroorthopaedics and Systemic Disorders, Saint-Petersburg, Russia
| | - Jochen G. Hofstaetter
- Ludwig Boltzmann Institute of Osteology, the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital
| | - Franz Grill
- Ludwig Boltzmann Institute of Osteology, the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital
| | - Rudolf Ganger
- Ludwig Boltzmann Institute of Osteology, the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital
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Forterre F, Casoni D, Tomek A, Karli P, Howard J, Precht C. Congenital cervical kyphosis in two young sighthounds. Vet Comp Orthop Traumatol 2015; 28:73-8. [PMID: 25487512 DOI: 10.3415/VCOT-14-08-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/03/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Cervical vertebral (C) malformation is rarely reported in large breed dogs. Congenital cervical kyphosis (CCK) may result from defects of vertebral segmentation, failure of formation or both. This report describes two cases of C3-C4 CCK in young sighthounds, treated surgically. CASE DESCRIPTION An 18-month-old female Deerhound and a six-week-old female Borzoi dog were presented because of the complaints of reluctance to exercise and signs of of neck pain. Both dogs were neurologically normal. Diagnostic imaging revealed C3-C4 deformity, moderate kyphosis, and spinal canal stenosis associated with chronic spinal cord pressure atrophy. Both dogs underwent surgical treatment. RESULTS A staged two-step surgery starting with dorsal decompression was elected in the Deerhound. After the first surgical procedure, the dog developed focal myelomalacia and phrenic nerve paralysis and was euthanatized. A ventral distraction-fusion technique with two locking plates was performed in the Borzoi. This patient recovered uneventfully and long-term follow-up computed tomography revealed complete spondylodesis. CLINICAL SIGNIFICANCE Until now, CCK has only been described in sighthounds. Congenital cervical kyphosis might be considered a differential diagnosis in these breeds that are presented with signs of cervical pain. Ventral realignment-fusion and bone grafting may be considered for surgical treatment, although the earliest age at which this procedure can and should be performed remains unclear.
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