short neck deformity
Introduction
Introduction to short neck deformity Short neck deformity refers to the fusion of two or more cervical vertebrae, mainly in the cervical spine shortening. basic knowledge The proportion of illness: 0.001% Susceptible people: good in the fetus Mode of infection: non-infectious Complications: recessive spina bifida sciatica
Cause
Cause of short neck deformity
This cervical spine malformation can be a fusion of all cervical vertebrae or several cervical vertebrae, or local fusion of vertebral bodies, lamina, vertebral arch and spinous processes. The cause of malformation is unclear. It is generally believed that during embryonic development, The interlobular tissue development disorder of the intervertebral disc should be formed. When the vertebral endplate matures, the intervertebral disc or cartilage does not occur until ossification, forming a fusion between the vertebral bodies. A few congenital cervical fusions are related to heredity.
Prevention
Short neck deformity prevention
The disease is a congenital disease and there are no effective preventive measures.
Complication
Short neck deformity complications Complications, recessive spina bifida, sciatica
Short neck deformity with cervical ribs, recessive spina bifida, nerve root or plexus malformation, can appear arm pain, low back pain and sciatica, with cardiac malformations, kidney deformities may also have corresponding clinical symptoms, in addition, short neck deformity can be Combined with scoliosis, high scapula and herd deformity.
Symptom
Symptoms of short neck deformity Common symptoms Short neck and neck activity restricted After spinal cord compression, low quadriplegia
There are three clinical features of congenital cervical fusion: the neck is short, the posterior hairline is low, and the neck activity is limited, but not all patients have the above characteristics. Gray et al believe that only 32% have typical triad.
1. Short and thick neck: It is often not obvious, but the neck is shorter than normal, and the face is asymmetrical. The skin on both sides of the neck from the mastoid to the shoulder is widened and has a wing-like neck.
2. After the hairline low level: the main performance is that the post-hairline is significantly lower than the normal person.
3. Limited cervical vertebra activity: Due to the fusion of the vertebral body, the range of motion of the cervical vertebra is obviously limited, and the rotation and lateral bending are particularly constrained. The multi-segment and full-section fusion activities are limited, single segment and lower segment. Segment integration is less obvious.
4. Short neck deformity caused by fusion of the upper cervical vertebrae, often combined with occipital neck deformity, more often in the early stage of neurological symptoms, mainly manifested by spinal cord compression caused by occipital instability.
5. Short-neck deformity caused by middle-lower cervical fusion, with no neurological symptoms in the early stage. With the increase of age, the activity of the non-fused cervical segment increases on the fusion vertebral body, and the strain and degeneration also occur one after another. Degenerative changes include thickening of the posterior margin of the vertebral body and thickening of the ligament structure, calcification. The above pathological changes will lead to spinal stenosis, and the buffer space of the cervical spinal epidural space will be reduced. Once a minor trauma is encountered, the neurological symptoms may be caused. Therefore, almost all of these patients have obvious neurological symptoms after suffering from minor trauma. The clinical features are light trauma, severe symptoms, and can cause quadriplegia, and X-ray examination does not show obvious signs of bone damage.
Examine
Short neck deformity examination
1. MRI can clearly show the segment of cervical fusion, and can determine the location and severity of spinal compression, which provides a reliable basis for the choice of treatment options. It is worth noting that in infants due to incomplete ossification of the vertebral body, fusion There is a transparent band between the vertebral bodies similar to the intervertebral disc. Careful observation will reveal that the transparent band is narrower than the normal intervertebral space.
2. Flexion and extension of the dynamic cervical lateral radiograph, the fusion of the vertebral segment lost the normal cervical spine curve, the intervertebral space does not change.
3. Short neck deformity is difficult to clearly show the deformed part on the X-ray positive lateral slice, showing the following characteristics:
1 Some or all of the two or more vertebrae and attachments of the cervical vertebrae fuse.
2 One or more intervertebral spaces disappear or partially disappear.
3 The vertebral body is flat and wide, sometimes a semi-vertebral deformity.
4 The vertebral body is adjacent to the cervical vertebra segment hyperplasia, degeneration, and the sagittal diameter of the spinal canal is reduced to form a spinal stenosis.
5 can be combined with other malformations.
Diagnosis
Diagnosis and differentiation of short neck deformity
The disease is distinguished from cervical spondylosis by typical symptoms (short neck and posterior hairline) and imaging related examinations.
