Friday, March 27, 2009

Butterfly vertebra- that mimics a wedge fracture is a uncommon congenital spinal anomaly.



A butterfly vertebra, which is an uncommon congenital spinal anomaly needs to be identified correctly as confused with other pathologic conditions like fractures, infections, and metastases (2). Garcia F et al reported 2 patients, who had injuries to the dorsal spine with diagnosed compression wedge fracture. Similarly a study presented by Patinharayil G et al showed anterior wedging (2). In both a careful study of the anteroposterior radiographs showed that the presumed injury was a butterfly vertebra. This rare congenital anomaly, which is usually without clinical significance, may be mistaken for a wedge fracture unless the anteroposterior view is correctly assessed (1).
Butterfly vertebra: an uncommon congenital spinal anomaly.
Butterfly vertebra presents with:
1. Complaints of low back pain (non-specific)
2. Spinal deformity such as (abnormal bony prominence)
3. Usually routine examination of the motor and sensory system usually is normal.

Investigations of importance:

Radiologic (X-ray, CT scan, MRI) and hematologic investigations. Hematologic evaluation must be done to rule out pathologic causes of anterior wedging of the vertebra like infections and metastases in the spine.

Knowledge of this condition helps in making rational use of extensive noninvasive and invasive diagnostic procedures.

References:

1. Garcia F et al; Int Orthop. 1993;17(1):7-10.

2. Patinharayil G et al; Spine. 2008 Nov 15;33(24):E926-8.

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