Pediatric Vertebral Body Anomalies

  • Etiology: failure of vertebral body formation or segmentation
  • Imaging:
    — Failure of formation – hemivertebra, butterfly vertebra, wedge vertebra
    — Failure of segmentation – fusion vertebra, block vertebra, vertebral bars
    — Accompanying rib anomalies: missing or supernumerary ribs, rib fusion, splitting of ribs
  • DDX:
  • Complications: scoliosis
  • Treatment:
  • Clinical: seen in 60-95% of VACTERL patients

Radiology Cases of Vertebral Body Anomalies

Radiology Cases of Hemivertebra

Angiogram of cross fused renal ectopia
AP image from a selective angiogram injection of the left renal artery shows fusion of the medial aspect of the left kidney, which has crossed the midline, to the medial aspect of the right kidney, causing the right kidney to be displaced laterally. A right hemivertebra is also present just above the T10 vertebral body.
CXR of congenital scoliosis due to hemivertebra
CXR AP shows a round soft tissue density in the superior and medial aspect of the right hemithorax which was found on cross sectional imaging to be in the posterior mediastinum, along with multiple hemivertebra segmentation anomalies of the lower cervical and upper thoracic spine causing a curvature of the upper thoracic spine convex to the right.
Radiograph of Klippel-Feil syndrome
AP radiograph of the cervical spine shows multiple segmentation anomalies including vertebral body fusion and hemivertebrae of the cervical spine and upper thoracic spine.
AXR of cloacal exstrophy
AXR shows diastasis of the symphysis pubis, multiple loops of bowel outside the contour of the abdomen inferiorly, and multiple segmentation anomalies in the lower lumbar spine and sacrum.

Radiology Cases of Butterfly Vertebra

CXR and CT of neurenteric cyst
CXR shows congenital scoliosis due to vertebral segmentation anomalies in the upper thoracic spine. Axial CT with contrast of the chest shows a cystic lesion to the right of the spine in the posterior mediastinum.

Radiology Cases of Block Vertebra

Radiograph and tomogram of congenital scoliosis due to congenital bar
AP radiograph of the lumbar spine (left) demonstrates a curvature of the thoracolumbar spine convex to the left caused by a fusion of the right sided pedicles of the L1 and L2 vertebral bodies which is better demonstrated on the tomographic image (right).