Cuneiform deformity of the vertebrae

Cuneiform vertebrae

The sphenoid vertebrae are a congenital or acquired pathology that is characterized by underdevelopment of the lateral or anterior vertebra. In most cases, this is a congenital anomaly, rarely occurs due to tumors, various injuries, infections, or granulomatous inflammation.

The disease can cause severe back pain or curvature of the spine. It often leads to the emergence of rapidly developing scoliosis, kyphosis, which leads to a worsening of the cardiovascular system and neurological pathologies.

A vertebra is a bone, which consists of a solid rectangular base, an arc, and appendages.

The entire load falls on the body of the vertebra, its posterior part and arc pass into the depression in which the spinal cord is located.

The appendages are connected with other vertebrae, between them there are intervertebral disks. The development of the spine is performed due to the epiphasic plate (the end of the bone).

During embryonic development, blood vessels can not grow correctly, this will lead to an underdeveloped bookmark of the backbone and the appearance of pointed vertebrae. Bone becomes not straight, but wedge shaped.

Types of sphenoid vertebrae

The wedge vertebrae are classified according to their growth potential. There are active and inactive deformations.

Active can develop and continue to grow.

This variant is unfavorable, since during the development of the human body the spine grows, and the anomaly increases.

The sphenoid vertebrae are a half-arch with small processes and the main body. They are divided into these types:

• multiple;
• single;
• double.

Two wedge-shaped vertebrae, located on different sides and at different heights, are called alternating. If there are more than three such deformations, a wide segmentation anomaly occurs.

The base of the vertebra consists of two wedge-shaped parts, which are connected by endings. The butterfly-shaped pathology is formed.

In addition, the wedge deformation is of several types:

• side (deformation of the right or left parts);
• front and rear (deformation of the front and back).

The disease occurs due to a violation of the nucleus of ossification in any zone of the spine. As a rule, the upper lumbar and lower thoracic zones are affected by pathology. This factor leads to the appearance of a hump.

Inactive vertebrae have an underdeveloped epiphasic zone and can not develop. In many cases, such deformations fuse with the higher or lower normal vertebrae. In this case, the vertebra is blocked.

Causes

The appearance of wedge-shaped deformations can be a consequence of the Sheyerman-Mau disease (a hereditary pathology transmitted through the male and female lines in a generation). Also, the causes that can lead to the formation of vertebral pathologies in embryonic development, can be called:

• malnutrition of the mother;
• various infections;
• hypertension in pregnant women;
• endocrine disorders;
• mental disorders of the mother;
• harmful and unsafe working conditions;
• pollution in the atmosphere, radiation, etc.

In healthy children, the appearance of wedge-shaped vertebra occurs in infancy, preschool and adolescence. Acquired pathology can be caused by:

• injuries;
• primary tumors;
• inflammatory processes;
• dystrophy;
• granulomatous diseases;
• metastatic changes in the vertebra.

The lateral sphenoid vertebra is a wedge-shaped bone mass that grows between healthy vertebrae. Such growths can be double and single.

They are located in the lumbar or thoracic region, as well as in the cervical.

According to statistics, the number of congenital pathologies in the spine, including the formation of wedge-shaped vertebrae, is growing every year.

The development of congenital wedge-shaped vertebrae in the thoracic region is the main cause of the development of severe forms of kyphosis (curvature of the spine, which leads to a hunchback or stoop).

If you do not start treatment, after 2-4 years, the thoracic part of the vertebra deforms, the thorax becomes flattened, mobility is limited. Such violations lead to a decrease in lung capacity and dysfunction of the cardiovascular system.

Symptoms and signs

The main signs of pathology are:

• a sharp pain in the area of ​​the back, which "stretches" to the waist with physical exercises, long standing or sitting;
• shortness of breath due to decreased lung volume;
• fast fatiguability;
• headache with deformities in the cervical region;

When examining the patient, one can notice a curvature of posture of different intensity - from a barely noticeable lateral curvature or kyphosis to the appearance of a hump. Strongly pronounced deformations are manifested in the discrepancy between the ribs on the left or right side.

The wedge-shaped curvature of the vertebral bodies is a serious dangerous disease that affects the whole way of life. If you do not start timely treatment, the situation may worsen and lead to:

• periodic pain;
• the onset of chronic diseases;
• crooked posture;
• malfunctioning of the respiratory, cardiovascular system;
• disruption of the gastrointestinal tract;
• displacement of internal organs.

Diagnostics

In order to assign the right and timely treatment, the doctor must examine each vertebra and the characteristic of wedge deformities.

Therefore, there are many methods of diagnosis. Each of them carries different information depending on the location and types of wedge vertebrae.

Let's consider each of them in more detail.

1. Magnetic resonance imaging (MRI)

This method of radiation diagnosis, which allows you to determine the condition of the vertebrae and the level of deviations. It is an analysis to determine the complete picture of the patient's condition. MRI provides an opportunity to study:

• vertebrae;
• disks;
• epidural space;
• spinal cord;
• dural sack of the spine.

Often the cause of the wedge pathology is the deformation of the spinal cord. Therefore, this method is prescribed to patients with signs that indicate the displacement and deformation of the sphenoid vertebrae.

1. Osteoscintigra or radionuclide method of investigation

It is a dyne from modern methods of radial diagnostics for the analysis of the functional state of the vertebrae and their deformations using diagnostic radiopharmaceuticals labeled with radionuclides.

This variant of diagnostics is necessary for suspicion of wedge deformation, especially relevant for metastatic spinal cord or spinal cord injury (secondary malignant formations).

As a rule, osteoscintigra is prescribed in combination with MRI for a more accurate picture. The radionuclide method of investigation has limited possibilities for examining local vertebrae curvatures.

1. X-ray computed tomography

This is a modern and accurate method of diagnosis, which makes it possible to obtain information about the state of internal organs. This methodology enables:

• give a comprehensive assessment of the condition of the spine and discs,
• to study the condition of paravertebral tissues;
• to find the place of defeat with high accuracy;
• to exclude or confirm the oncological nature of deformation.

X-ray computed tomography has some disadvantages. First, the study makes it possible to determine the level of pathology development only at the level of several vertebral segments.

Secondly, the results of the analysis are reproduced in the axial surface, which does not make it possible to obtain a high-quality image.

Thirdly, information about the tissues of the spine is incomplete.

Another drawback of this study can be called harmful effects of ionizing radiation on the patient's body.

The method is used in the analysis of the degree of lesion of bone systems, postoperative observation, in the analysis of the effectiveness of radiotherapy and in the application of metal structures.

1. Spondylography and rectilinear tomography

Radiography is characterized by limited application due to the low number of projections, low resolving power, overlays of projections that do not give a full assessment of the affected area.

Conducting spondylography and rectilinear tomography makes it possible to differentiate the pathological defects of the spine.

As a result of the research, you can get accurate information about the vertebrae, discs, and also about the bony canals.

Treatment

The treatment process depends on the causes of pathologies, types of wedge-shaped vertebrae, the speed of development of the anomaly, and the general condition of the patient. Before the appointment of a doctor, the doctor studies the contraindications to each of the treatment options.

If the anomaly is caused by other diseases, it is very important to analyze the patient's health and develop the right treatment tactics.

If the patient has mild kyphosis or the initial stage of scoliosis, manual therapy, corsets, massage, exercise therapy and physiotherapy measures are allowed.

Conservative method

The wedge vertebrae need not be surgically removed. Small underdeveloped single vertebrae can only partially affect the way of life.

Their education enables doctors to give good prognosis of treatment.

In some cases, the formation of wedge-shaped vertebrae is accompanied by other disorders of the internal organs, in which surgical intervention is unacceptable.

For example, in the case of Sheyerman-Mau disease or moderate scoliosis, conservative methods of treatment are prescribed. It is not advisable to resort to surgical operations.

Conservative treatment with sphenoid vertebrae:

1. Exercise therapy;
2. massotherapy;
3. aqua aerobics and swimming;
4. manual therapy;
5. resort and sanatorium rehabilitation;
6. use of orthopedic corsets.

The patient should perform simple exercises every day that will help to recover:

• crawling on all fours;
• crawling with swinging of the hands and stretching of the legs;
• walking with inclines left / right;
• walking with a wave of hands;
• crawling kneeling without support;
• rotation of the trunk.

Surgical intervention

With severe abnormalities of the vertebrae, which are rapidly developing and carry a threat to the life of a person, affecting his life, a surgical method of treatment is used.

Since the forms of development of the wedge-shaped vertebrae can be congenital and acquired in adulthood or childhood, the nature and timing of the operation is assigned individually based on the general condition of the patient and the nature of the course disease.

The main methods of surgical intervention:

• rear spidylodesis without the use of tools;
• rear spoidylodesis with instrumentation (implanted metal implants that increase resistance spine, partially correct deformations, minimize the degree of localization from the quality of the external immobilization);
• spondylodesis (a surgical method of treatment aimed at forming a fusion between adjacent vertebrae when a special bone graft is transformed between them);
• anteroposterior epiphysis-spondylodesis consists in blocking the spine on some extent; the growth of bone tissue on the convex part of the vertebra stops, but remains on the concave zone;
• the excision of the semi-vertebra is to remove the body and correct the deformation.

Modern technologies in medicine can diagnose and heal wedge deformations. But the most effective way, as with any disease, is prevention.

A healthy lifestyle, a balanced diet, moderate stress, observance of elementary safety rules, control of posture in children, timely treatment of various diseases reduces the likelihood of wedge-shaped vertebrae.

Prevention

Future mothers need to lead a healthy lifestyle, abandon bad habits, avoid conflict situations, do not get nervous and promptly treat emerging diseases.

To prevent the acquired form of deformation, you should avoid injuries.

Which doctor heals

Orthopedics and vertebrologists are involved in the treatment of wedge-shaped deformities. Also, patients in diagnosis visit other specialists - cardiologists, pulmonologists and neurologists.

A source: http://www.knigamedika.ru/kost/osteo/klinovidnye-pozvonki.html

Cuneiform vertebrae

Wedge-shaped phonecalls(semi-vertebrae) - vertebrae of irregular shape, consisting of half-body and half-arches with an appendage.

As a rule, they are a congenital anomaly of development, they are less often formed due to traumas, tumors, granulomatous and infectious diseases.

They can be single or multiple, more often localized in the lower thoracic and upper lumbar spine. They become the cause of curvature of the spine and back pain.

In a number of cases, a rapidly progressing scoliosis (less kyphosis) and, as a result, the appearance of neurologic disorders, deterioration of the functions of the heart and lungs, is caused.

For the diagnosis is used radiography, MRI, CT, scintigraphy and radionuclide method. Therapeutic tactics depend on the cause and type of pathology. Usually prescribed exercise therapy, wearing a corset, massage, manual therapy and physiotherapy. In a number of cases, surgical treatment is indicated.

The sphenoid vertebrae are deformed vertebrae, which are bones of a wedge shape with an undeformed or destroyed second half.

Most often they are congenital malformations, although they can also form in some pathological processes in the spine. Cause the curvature of the vertebral column in the lateral (scoliosis) or, less often, anteroposterior (kyphosis) direction.

Treatment of wedge-shaped vertebrae and deformations caused by this pathology is performed by orthopedists and vertebrologists.

A normal vertebra is a complex bone, consisting of a rectangular body, arches and processes.

The massive body of the vertebra carries the main burden, the posterior surface of the body and the arch form the receptacle for the spinal cord, the processes serve to connect with other vertebrae.

Intervertebral discs are located between the vertebral bodies. Like other bones, the growth of the vertebrae is due to the marginal zone - the epiphyseal growth plate.

With improper ingrowth of blood vessels in the intrauterine period, half of the laying of the vertebral body remains undeveloped, as a result, the bone acquires not a rectangular shape, but a wedge shape.

The cause of the formation of anterior and posterior wedge-shaped deformations is the underdevelopment of the anterior or posterior nucleus of ossification.

Anomaly can occur in any part of the spine, however, it is more common in the lower thoracic and upper lumbar regions. Deformed vertebrae can be single, double or multiple.

Two wedge-shaped vertebrae, located between 2-3 normal vertebrae and representing a mirror reflections of each other (in one underdeveloped right half, in another - left) bear the name alternating.

This is a favorable variant of the pathology, since the deformations of the vertebrae are mutually "neutralized" and the curvature is of a local nature.

Several wedge-shaped vertebrae, underdeveloped on the same side, are rare and are more severe spinal anomalies.

Depending on the ability to grow, active and inactive wedge-shaped vertebrae are isolated. In the active vertebrae, the growth zone is preserved.

This is an unfavorable variant, as the vertebra grows as the child grows up, and the deformation of the spine is aggravated.

This pathology can be detected in the Sheyerman-Mau disease - a hereditary anomaly that is transmitted both over the male and female lines.

Among other factors that can adversely affect the development of the vertebrae in the intrauterine period - endocrine infectious diseases and maternal malnutrition, stress during pregnancy, harmful working conditions and poor ecology. Acquired deformity of the vertebrae can occur as a result of injuries, granulomatous, infectious and inflammatory diseases, dystrophic processes, primary tumors and metastatic lesions the spine.

Symptoms and signs of sphenoid vertebrae

Patients complain of back pain and fatigue during physical exertion, prolonged sitting or standing. Patients also often complain of shortness of breath, resulting from impaired lung function. Headache may occur in the cervical hemispheres.

With an external examination, there are violations of posture of varying severity - from slight lateral curvature or kyphosis strengthening to a pronounced hump. Significant curvatures are accompanied by deformation of the chest and divergence of intercostal spaces on one side.

Diagnosis of sphenoid vertebrae

The presence of wedge-shaped vertebrae is confirmed by additional studies.

One of the simplest and most accessible methods of research in this pathology is the radiography of the spine, however, X-ray images may not be sufficiently informative.

Using this technique, it is possible to identify the developed wedge-shaped bone mass at the site of the normal vertebra, however Undeveloped alternating vertebra, which can be represented only by part of the arch, sometimes remains unrecognized.

In addition, radiography does not allow to assess the state of intervertebral discs, the degree of development of the epiphyseal growth zone and other details important for determining the further treatment tactics.

The most informative technique, allowing to assess the condition of the vertebrae, intervertebral discs, spinal cord, dural sac and epidural space, is the MRI of the spine.

With metastatic lesions, in addition to MRI, a radionuclide study and a CT scan of the spine can be used to refine the diagnosis.

These techniques allow us to identify local pathology and objectively assess the condition of the affected vertebra, confirming or eliminating the oncological nature of the deformity. However, the techniques have certain drawbacks.

According to the testimony of patients with wedge-shaped vertebrae, they are referred for consultations to other specialists: neurologist, pulmonologist and cardiologist. When detecting pathology from other organs and systems, appropriate studies are performed: ECG, spirometry, etc.

Therapeutic tactics are determined taking into account the causes and appearance of the wedge-shaped vertebrae (single, multiple, active, blocked), a prognosis regarding the progression of the deformity, as well as the general condition of the patient and the presence of contraindications to that or other type of treatment. The latter two factors are particularly important in the case of acquired wedge-shaped deformations that have arisen due to other diseases.

With mild and moderate non-progressive kyphosis and scoliosis, a conservative treatment, which includes corsetting, exercise therapy, manual therapy, massage and physiotherapy procedures.

With severe progressive distortions, ineffective conservative therapy, abnormalities of organs and systems, surgical treatment is indicated. The nature of surgical intervention depends on the characteristics of the pathology.

It is possible to perform a simple posterior fusion, a posterior fusion with the use of metal structures, excision of the semi-vertebral column, anteroposterior frontal spondylodesis.

In the treatment of pediatric patients with active semi-vertebrae, an anteroposterior epiphysis-spinal fusion is effective, which allows to stop the growth of the vertebra on the convex side of the curvature.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/wedge-shaped-vertebrae

What is a wedge-shaped deformation of the vertebrae

The wedge-shaped form of the vertebra can acquire under the influence of numerous factors. This form appears as a result of underdevelopment or deformation of the anterior and lateral parts of the vertebral body.

The habitual and normal cylindrical shape of the vertebra changes, taking the form of a wedge.

This leads to disturbances in the normal functioning of the affected spine, the appearance of pain and other clinical symptoms of the sphenoid vertebra.

The sphenoid deformity of the vertebrae becomes one of the most common and widespread causes of spinal instability. This condition can cause serious deformities of the spine until the appearance of the hump.

The causes of wedge-shaped vertebrae

Cuneiform deformations can occur in both children and adults. In childhood, the cause of the formation of wedge-shaped vertebrae are:

• Hereditary genetic disorders.
• Infectious diseases, hypertension and lesions of the endocrine system during pregnancy.
• Serious stressful situations, borne by a pregnant woman.
• Irrational unbalanced (insufficient or excessive) nutrition of the mother during pregnancy.
• Dangerous working and environmental conditions.
• Injuries of the back, borne by the child at different ages.
• Inflammatory, infectious or oncological diseases.

In adults, the main causes of the appearance of wedge-shaped vertebrae are:

• Various injuries.
• The presence of dystrophic processes.
• Metastases with cancer.

Symptoms of the disease

The wedge-shaped deformation of the vertebrae leads to the appearance of such symptoms and signs:

• A hardly noticeable or very pronounced (up to the formation of a hump) physical deformation of the spine and thorax.
• Pain in the spine and back, having different intensity and properties - from aching to strong permanent or shooting at movement.
• Headaches, most frequent with wedge-shaped deformation of the cervical vertebrae.
• Fatigue, which occurs even with a slight and short load.

The patient vertebrae can be located one at a time, in pairs or in several pieces at once. The more deformed vertebrae, the deeper the health problem and the more pronounced curvature of the spine.

Treatment of wedge deformation

In most cases, the wedge-shaped deformation of the vertebrae is treated with complex conservative methods.

Only in exceptional cases, when it is not possible to cope with the problem, surgical methods - from operations to change the shape of the vertebrae before its removal or use of metal containing constructions.

If there are single sphenoid vertebrae and the treatment is started at the initial stages of the disease, the prognosis is positive, which guarantees a good quality of life and even a complete cure.

The main methods of conservative treatment:

• Wearing a special orthopedic correction corset, matched individually.

• Manual therapy.
• Physiotherapy.
• Massages.
• Physiotherapy.
• Swimming and performing special exercises in the pool.
• Treatment and prevention in specialized sanatoriums and resorts.

Treatment of the disease is long, depends on the degree of severity of the process and the rational approach of the patient.

If you do not let the disease run its course, but take quick and decisive measures, the most serious consequences will be avoided.

A healthy lifestyle, rejection of bad habits, rational nutrition and accurate adherence to the doctor's instructions will help get rid of pain and significantly change the situation for the better.

The sphenoid deformity of the vertebrae also can not resist the strength of the water procedures - water relieves the load from the diseased spine and allows the patient to more actively develop it.

Sanatorium treatment positively affects the immunity of the patient and significantly strengthens both general health and spine.

Applying all these methods consistently in the complex will bring good results and will help the patient with wedge deformation to cope with the manifestations of the disease.

A source: http://spina-info.ru/chto-predstavlyaet-soboj-klinovidnaya-deformaciya-pozvonkov/

Degree of sphenoid deformity of the vertebrae

The spine supports the whole body, it belongs to the most important organs. Problems with the vertebral column cause serious diseases of the internal organs. One of these problems is the violation of the structure of the vertebrae.

The sphenoid deformity of the vertebrae can be congenital or acquired. It is characterized by destructive processes, underdevelopment of the lateral or anterior spine.

As a result, there is a violation of the evenness of the spine in these departments, which leads to heart disease. A full vertebra is a bone with processes and arches. The vertebral body assumes the main load, while the arc and the back part deepen.

Between each other the vertebrae are connected by processes, they are responsible for the growth and development of the vertebrae. The body of the vertebra does not fully develop, if the blood vessels are not yet properly embedded in the womb.

Types of sphenoid vertebrae

The main body and not a full arc with small processes distinguish wedge-shaped vertebrae from ordinary vertebrae. They are divided into classes according to growth.

The wedge-shaped deformation of the vertebral body happens:

1. single form;
2. double type;
3. multiple species.

Developmental disorders can be active or inactive. In the first case, the problem is constantly aggravated, as development and growth take place. This leads to constant deformation of the spine as the child grows.

A pair of vertebrae located opposite one another are called alternating. This type of pathology is much more favorable, since it is a question of a local process.

Types of vertebral development disorders

If more than 2 vertebrae are formed incorrectly, an anomaly of segmentation occurs. Two parts of the sphenoid base of the vertebrae connected by apexes form pathology in the form of a butterfly.

Deformity of the vertebrae may be anterior and posterior or lateral. In the latter variant, the pathology is observed from one side. Most often, the problem occurs in the lower chest and upper lumbar spine.

This is due to the appearance of a hump.

Underdevelopment of the epiphasic zone does not allow developing inactive vertebrae. In this case, they fuse with a healthy neighboring vertebra, while blocking occurs.

Degrees of deformation are determined by the type of problem and the duration of its development. To this pathology, certain provoking factors are carried out. Each problem occurs for a reason and this is no exception.

The causes of deformation of the sphenoid vertebrae

It is worth paying attention to the fact that the number of congenital deformities of the spine is rapidly increasing every year. The main causes of the congenital problem are:

• malnutrition of the pregnant woman;
• genetic predisposition;
• infectious diseases;
• disease of the endocrine system;
• high blood pressure;
• adverse ecology;
• heavy physical labor and stress of the future mother.

The problem can arise in healthy children. It can happen both in early childhood and in adolescence.

In this case, the sphenoid deformity of the vertebrae is provoked:

• Traumatic effects on the back;
• Inflammation;
• Metastatic changes of the spinal column;
• Infectious pathogens;
• Dystrophy;
• Granulomatous diseases.

Adults may be affected by metastatic changes and dystrophic conditions. And also traumatic back injuries. The disease can be determined by the main characteristics.

Symptoms of pathology

The main symptoms include:

1. Aching or sharp pain in the region of the back, giving to the lower parts;
2. Rapid fatigue in the horizontal or vertical position and under loads;
3. Disorders of posture, regardless of degree;
4. The appearance of dyspnea as a result of a malfunction in the lungs;
5. Headaches if the problem is localized in the cervical region.

If one or more symptoms are found, you should immediately contact a doctor and diagnose the disease. Only then will a decision be made regarding the method of solving the problem.

Treatment of pathological process

Getting rid of the problem can be carried out both conservatively and surgically. The first option is applicable for moderate scoliosis, problems with internal organs.

Conservative treatment includes:

• wearing a special corset;
• exercise therapy;
• Spa treatment;
• massage courses;
• acupuncture;
• swimming and water aerobics.

Indication for surgical intervention is the inefficiency of the conservative approach and a direct threat to the full functioning of the body.

In any case, you can not leave this issue without attention, because the disease is quite dangerous and can lead to a wheelchair.

A source: http://medinovo.ru/klinovidnaya_deformatsiya_pozvonkov.html

The sphenoid vertebrae (semi-vertebra)

Patients complain:

• on back pain and increased fatigue during physical exertion, prolonged sitting or standing;
• dyspnea due to worsening lung function;
• Headache may occur in the cervical hemispheres.

With an external examination, there are violations of posture of varying severity - from slight lateral curvature or kyphosis strengthening to a pronounced hump. Significant curvatures are accompanied by deformation of the chest and divergence of intercostal spaces on one side.

The wedge-shaped deformation of vertebral bodies is quite a serious disease, which can significantly worsen the quality of life. It inevitably leads to:

• violation of posture, which causes the displacement of internal organs;
• violation of the cardiovascular, digestive, respiratory systems;
• development of other chronic diseases;
• constant pain.

Treatment of the disease

Therapeutic tactics are determined taking into account the causes and appearance of the wedge-shaped vertebrae (single, multiple, active, blocked), a prognosis regarding the progression of the deformity, as well as the general condition of the patient and the presence of contraindications to that or other type of treatment. The latter two factors are particularly important in the case of acquired wedge-shaped deformations that have arisen due to other diseases.

With mild and moderate non-progressive kyphosis and scoliosis, conservative treatment is prescribed, which includes:

• corsetting - wearing orthopedic corsets;
• exercise therapy;
• manual therapy;
• massage;
• physiotherapeutic procedures;
• swimming and special exercises in the water;
• Spa treatment.

With severe progressive distortions, ineffective conservative therapy, abnormalities of organs and systems, surgical treatment is indicated. The nature of surgical intervention depends on the characteristics of the pathology. It is possible to hold:

• simple posterior spondylodesis without instrumentation;
• back fusion with the use of tools, that is, the addition of metal implants, which allows to increase stabilization of the spine, reduce dependence on the quality of external immobilization and more deformation;
• half-vertex excision;
• anteroposterior spondylodesis.

In the treatment of pediatric patients with active semi-vertebrae, an anteroposterior epiphysis-spinal fusion is effective, which allows to stop the growth of the vertebra on the convex side of the curvature.

But the most effective treatment is still simple prevention, from the period of intrauterine development and ending with deep old age.

Proper nutrition, moderate exercise, control of posture in children, caution when lifting weights and observing simple rules safety, to avoid injuries, timely treatment of inflammatory processes, will help many times reduce the likelihood of formation sphenoid vertebrae.

Diagnosis of the disease

The presence of wedge-shaped vertebrae is confirmed by additional studies.

Spondylography and rectilinear tomography.Assessing the possibilities of spondylography and rectilinear tomography, most researchers agree that in this clinical situation, the methods of traditional X-ray studies have limited application due to the small number of projections, low resolution, projection layers, which hinder adequate assessment of the area defeat.

Therefore, many authors, describing the possibilities of traditional radiology in the differential diagnosis of wedge-shaped deformations of the vertebrae, use the terms of probability, but not confidence.

X-ray computed tomography (CT). PCT is more useful in distinguishing pathological conditions leading to the appearance of wedge-shaped deformations of the vertebrae. Thus, with the help of RKT, a more accurate characterization of the condition of the affected vertebra, disk, paravertebral soft tissues, and a more accurate definition of the pathomorphological substrate of the lesion are permissible.

Additional potentials inform the method of the possibility of carrying out contrast enhancement, which allows to exclude or confirm the oncological nature of the process. However, the means and methods of PCT can estimate the prevalence of the pathological process only at the level of one or more vertebral segments.

Almost never this can be done all over the spine or even during one of its departments. Reconstruction of the RTD in any other plane, except for the axial, does not always give good quality visual information, which would allow a full-fledged diagnostic analysis. Due to the physical characteristics of the imaging, the ability of RKT to display the contents of the vertebral channel is not so high, and this also reduces its capabilities in the differential diagnosis of wedge deformations vertebrae.

And, finally, in carrying out RCT, the harmful effect of ionizing radiation on the patient still remains. Speaking about the place of RKT in the algorithm of radial examination with wedge-shaped deformations of the vertebrae, many authors agree that RKT is a method of the second choice. The method is good in assessing the lesion of bone structures, in planning and conducting directed biopsies, with postoperative control, especially in the case of metal structures, in evaluating the results of radiation therapy.

Radionuclide method.Radionuclide method (osteoscintigraphy) is also used for differential diagnostics of wedge deformations of the vertebrae. In particular, scintigraphy is considered a highly sensitive method of detecting vertebral metastases, its sensitivity is 72-95%. S.

Eustace et al. (1997) compared the diagnostic capabilities of MRI and scintigraphy with 99mTc-methylene diphosphonate in the detection of metastatic skeletal lesions, to which 25 patients were examined. According to these authors, for the scintigraphy the sensitivity of the method was 72%, specificity 98%, the predictive value is 95%, and for MRI sensitivity is 9%, specificity is 100%, prognostic the value is 100%.

Researchers suggest using bone scintigraphy with 99mTc-methylene diphosphonate in combination with MRI. There are also limited possibilities of scintigraphy in the differential diagnosis of local vertebral lesions, their wedge-like deformations.

Magnetic resonance imaging (MRI).Observations of the above authors confirm the view that MRI should be the first choice in the differential diagnosis of wedge-shaped deformations of the vertebrae. The human bone, in particular the vertebrae, is a living organ that consists not only of bone tissue, but also of bone marrow, cartilaginous, vascular, lymphoid, nerve, connective tissue elements.

The methods of classical radiology, RVT and scintigraphy, due to the physical features of imaging, help in studying the basically mineralized bone core. Other components of the bone organ remain behind the scenes. At the same time, MRI provides information about all the components of the bone and surpasses the listed methods of radiation diagnosis in mapping the bone marrow in its normal and pathological state.

This is especially important, since it is the damage to the bone marrow that is often the cause of the pathological vertebral fracture, its wedge-shaped deformation. MRI provides exhaustive information about the condition of the vertebrae, discs, epidural space, dural sac and spinal cord.

In addition, MRI provides more objective criteria for analyzing the diagnostic image, this is an estimate signal characteristics of the studied area on images of different types of weighting, and also in conditions of contrast gain. According to most researchers, all this makes it possible to confidently build the final diagnosis and MRI as the first choice in the differential diagnosis of wedge deformities vertebrae.

A source: https://israel-clinics.guru/diseases/klinovidnyje_pozvonki_polupozvonki_/

Cuneiform deformity of the vertebrae (radiodiagnosis)

...quite a frequent symptom, revealed by X-ray examination. At the same time, the interpretation of this sign is rather complicated, because the causes that cause it are very diverse.

Wedge-shaped deformationone or more vertebrae - a serious clinical situation, which for the most part is a consequence of trauma, osteoporosis, metastatic or inflammatory lesion.

According to the literature, in adults, most often the wedge-shaped deformation of the vertebral bodies is noted in traumas, dystrophic processes, metastatic lesions, in children is formed as a result of developmental anomalies, granulomatous and inflammatory diseases. The complexity of the problem is often due to the lack of specificity of clinical symptoms, as well as the combination of pathological processes in the same patient.

For example, osteoporosis and metastatic damage are a common combination in elderly patients, they can also have an inflammatory process. At the same time, pathoanatomical studies have shown that in patients with oncological anamnesis in 30% cases, wedge-shaped deformations of the vertebrae are treated as metastatic, although they are caused by other reasons. In 25% of cases, pathological fractures and wedge-shaped deformations that develop as a result of metastases in the vertebrae are not recognized and are explained by dystrophic or other lesions.

In this connection, it is clear that the issue of differential diagnostics of wedge-shaped deformations of the vertebrae is widely discussed both in Russian and foreign literature.

Consider the results of an analysis of individual methods of radiation diagnosis, and algorithms for complex radiation research in differential diagnosis of the symptom "wedge-shaped deformation of the vertebral bodies conducted by N.V. Gunicheva, V.N. Shubkin (Krasnoyarsk State Medical academy of them. prof. V.F. Voino-Yasenetsky) and T.A. Akhadov (Research Institute of Emergency Children's Surgery and Traumatology, Moscow).

Spondylography and rectilinear tomography.

Assessing the possibilities of spondylography and rectilinear tomography, most researchers agree that in this clinical situation, the methods of traditional X-ray studies have limited application due to the small number of projections, low resolution, projection layers, which hinder adequate assessment of the area defeat. Therefore, many authors, describing the possibilities of traditional radiology in the differential diagnosis of wedge-shaped deformations of the vertebrae, use the terms of probability, but not confidence.

X-ray computed tomography(RKT). PCT is more useful in distinguishing pathological conditions leading to the appearance of wedge-shaped deformations of the vertebrae.

Thus, with the help of RKT, a more accurate characterization of the condition of the affected vertebra, disk, paravertebral soft tissues, and a more accurate definition of the pathomorphological substrate of the lesion are permissible.

Additional potentials inform the method of the possibility of carrying out contrast enhancement, which allows to exclude or confirm the oncological nature of the process.

However, the means and methods of PCT can estimate the prevalence of the pathological process only at the level of one or more vertebral segments. Almost never this can be done all over the spine or even during one of its departments.

Reconstruction of the RTD in any other plane, except for the axial, does not always give good quality visual information, which would allow a full-fledged diagnostic analysis.

Due to the physical characteristics of the imaging, the ability of RKT to display the contents of the vertebral channel is not so high, and this also reduces its capabilities in the differential diagnosis of wedge deformations vertebrae.

And, finally, in carrying out RCT, the harmful effect of ionizing radiation on the patient still remains. Speaking about the place of RKT in the algorithm of radial examination with wedge-shaped deformations of the vertebrae, many authors agree that RKT is a method of the second choice. The method is good in assessing the lesion of bone structures, in planning and conducting directed biopsies, with postoperative control, especially in the case of metal structures, in evaluating the results of radiation therapy.

Radionuclide method. Radionuclide method (osteoscintigraphy) is also used for differential diagnostics of wedge deformations of the vertebrae.

(1997) compared the diagnostic capabilities of MRI and scintigraphy with 99mTc-methylene diphosphonate in the detection of metastatic skeletal lesions, to which 25 patients were examined.

According to these authors, for the scintigraphy the sensitivity of the method was 72%, specificity 98%, the predictive value is 95%, and for MRI sensitivity is 9%, specificity is 100%, prognostic the value is 100%.

Researchers suggest using bone scintigraphy with 99mTc-methylene diphosphonate in combination with MRI. There are also limited possibilities of scintigraphy in the differential diagnosis of local vertebral lesions, their wedge-like deformations.

Magnetic resonance imaging(MRI). Observations of the above authors confirm the view that MRI should be the first choice in the differential diagnosis of wedge-shaped deformations of the vertebrae.

The human bone, in particular the vertebrae, is a living organ that consists not only of bone tissue, but also of bone marrow, cartilaginous, vascular, lymphoid, nerve, connective tissue elements.

The methods of classical radiology, RVT and scintigraphy, due to the physical features of imaging, help in studying the basically mineralized bone core. Other components of the bone organ remain behind the scenes.

At the same time, MRI provides information about all the components of the bone and surpasses the listed methods of radiation diagnosis in mapping the bone marrow in its normal and pathological state.

This is especially important, since it is the damage to the bone marrow that is often the cause of the pathological vertebral fracture, its wedge-shaped deformation.

In addition, MRI provides more objective criteria for analyzing the diagnostic image, this is an estimate signal characteristics of the studied area on images of different types of weighting, and also in conditions of contrast gain. According to most researchers, all this makes it possible to confidently build the final diagnosis and MRI as the first choice in the differential diagnosis of wedge deformities vertebrae.

A source: http://doctorspb.ru/articles.ph? rticle_id = 2177