Diffuse skull base/cervical fusion syndromes in two siblings with spondylocostal dysostosis syndrome: analysis via three dimensional computed tomography scanning.
METHODS
A study on a pair of male sibs to reach for the etiological understanding of unusual skull base/spine maldevelopment.


OBJECTIVE
Previously, radiographs alone were used to formulate this diagnosis. Here, three-dimensional computed tomography (3D CT) studies further clarified the typical diagnostic findings associated with spondylocostal dysostosis (SCD). Interestingly, patients with SCD are at increased risk for diffuse skull base/cervical fusion syndromes and can result in severe neurologic deficits associated with any degree of trauma.


BACKGROUND
Classically SCD is defined as a skeletal dysplasia with clinical and radiologic manifestations, consisting of short neck and trunk, nonprogressive scoliosis and abnormalities of vertebral segmentation and of the ribs. Radiograms have been adopted as the only modality for the classification and prognostication of patients with SCD.


METHODS
Detailed clinical and radiographic examinations were undertaken with emphasis on the significance of the 3D CT scanning.


RESULTS
We observed extensive fusion of the clivus with the cervical/entire spine, resulting in a remarkable solid, immobile, and fixed bony ankylosis of extremely serious outcome.


CONCLUSIONS
Patients with spondylcostal dysostosis are predisposed to develop extensive skull-base-cervical spine fusion. The latter might lead to the development of a solid, immobile, and fixed bony ankylosis. In children/adults trivial injuries and/or high-energy trauma can lead to serious intracranial and spinal cord injury. Comprehensive orthopedic and neurosurgeons management must follow the recognition of these anomalies. To the best of our knowledge, no previous CT studies of the spine have been published in patients with SCD.
Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, AUVA Trauma Centre Meidling, 4th Medical Department, Hanusch Hospital, Vienna, Austria. ali.alkaissi@osteologie.at
Ali
A
Al Kaissi
Farid
F
Ben Chehida
Maher
M
Ben Ghachem
Klaus
K
Klaushofer
Franz
F
Grill
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D000293:Adolescent; D000844:Ankylosis / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000002:abnormalities / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D004413:Dysostoses / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D035781:Siblings; D019291:Skull Base / Q000002:abnormalities / Q000000981:diagnostic imaging*; D013577:Syndrome; D014057:Tomography, X-Ray Computed