A very rare case of cervicothoracic vertebral synostosis spanning eight adjacent segments: congenital vs acquired

Abstract

Cervical roentgenogram revealed a long-segment cervicothoracic

vertebral fusion spanning 8 adjacent spinal levels. The patient was

evaluated with computed tomography (CT) and magnetic resonance

(MR) imagings of the spine, electromyography (EMG) and growth

differentiation factor 6 (GDF6) gene mutation analysis. Imaging

findings were atypical for congenital block vertebrae and there

was no GDF6 mutation. A revision of very old medical records and

patient’s recollections revealed long-term stay in sanatorium for

rehabilitation of chronic partially-treated brucella spondylodiscitis

during adolescence. Block vertebrae spanning several levels have

previously been reported; but, this is the first report of an acquired

cervicothoracic fusion spanning 8 adjacent vertebral bodies.

Keywords

• Cervicothoracic vertebral synostosis,Klippel – Feil syndrome,Magnetic resonance imaging,Brucellosis,Growth differentiation factor 6

Sekiz ardışık segmenti kapsayan çok nadir bir servikotorakal vertebral sinostoz olgusu: konjenital mi, edinsel mi?

Abstract

Yaşlı bir kadın hasta travma sonrası akut boyun ağrısı ile başvurdu.

Servikal direkt grafisinde 8 ardışık spinal seviyeyi kapsayan

uzun segment servikotorakal vertebral füzyon saptandı. Hasta

spinal bilgisayarlı tomografi (BT) ve magnetik rezonans (MR)

görüntüleme, elektromiyografi (EMG), ve büyüme-farklılaşma

faktörü 6 [Growth differentiation factor 6 (GDF6)] gen mutasyonu

analizi ile detaylı tetkik edildi. Görüntüleme bulguları konjenital

blok vertebra için atipik olan olguda GDF6 gen mutasyonu

saptanmadı. Hastanın eski tıbbi raporları ve anamnezinde adolesan

dönemde kronik ve kısmen tedavi edilmiş brucella spondilodiskiti

rehabilitasyonu amacıyla sanatoryumda uzun dönemli yatış

mevcut idi. Birkaç seviyeyi kapsayan blok vertebra olguları daha

önceden bildirilmiş olmakla birlikte; bu, 8 ardışık vertebral cismi

kapsayan ilk edinsel servikotorakal füzyon olgusudur.

Keywords

• Servikotorakal vertebral siyanoz,Klippel- Feil sendromu,Magnetik rezonans görüntüleme,Brusellozis,Büyüme-farklılaşma faktörü 6

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