Incidence of Block Vertebrae in South Indians: An Osteometric Study

Abstract

BACKGROUND: Fusion of consecutive vertebral segments results in block vertebrae or vertebral synostosis or spinal fusion. The fusion may be complete or incomplete involving the bodies of the vertebrae alone or along with vertebral arch. It affects most commonly the cervical region, followed by thoracic and lumbar regions. AIM: The present study was aimed to assess the incidence of block vertebrae in south Indian population. METHODS AND MATERIAL: We examined a total of 2400 fully ossified dried vertebrae collected for a period of 4 years in Department of Anatomy, Dr. VRK Women's Medical College. RESULTS AND CONCLUSIONS: The study revealed 6 different specimens of block vertebrae, with 4 cervical, 1 cervico-thoracic and 1 thoracic vertebral synostosis. The features of these block vertebrae were analysed in detail and photographed from different aspects. The total incidence of block vertebrae was found to be 0.25%. The embryological significance and clinical implications of block vertebrae at various levels have been discussed in this paper.

A rare case of surgically managed multiple congenital thoraco-lumbar and lumbar block vertebrae with kypho-scoliosis and adjacent segment disease with myelopathy in a young female

“…Fusion of vertebra at single or multiple levels is referred to as block vertebra or vertebral synostosis. 1 Cervical block vertebra are most commonly noticed followed by thoracic and lumbar spine. 3 The incidence of Spinal block vertebra has been shown to be 0.25% in South Asian population.…”

“…Spinal block vertebrae is a rare condition involving 0.25% of South Asian population. 1 In western world, 2.6%, 1.6% and 0.5% congenital fusions have been reported in cervical, thoracic and lumbar vertebra respectively. 2 As per a recent study, it has been shown that the thoracic and thoraco-lumbar spine is less affected by congenital fusion of the vertebral bodies.…”

“…3 Moreover, such patients also suffer from deformity of the respective region when encountered with block vertebra. 1 Though a few case reports on the management of cervical block vertebra exist, there is little information on the surgical management of a case with thoraco-lumbar block vertebra with adjacent level disease. 4,5 This is the first report which enlists a case of congenital thoraco-lumbar block vertebra in an Asian female with lumbar kypho-scoliosis and adjacent level disease with myelopathy which was managed with minimal possible instrumentation.…”

Congenital Synostosis of Cervical Vertebrae: An Osteological Study and Review of the Literature

“…Sharma et al studied 48 dried adult vertebral columns and noted CFCV in 6.25%, fused thoracic vertebrae in 4.16%, and fused lumbar vertebrae in 2.08% [5]. Nazeer et al examined 2,400 ossified dried vertebrae and encountered CFCV in 0.5%, fused thoracic vertebrae in 0.08%, and fused lumbar vertebrae in 0% [4], whereas, according to Deepa et al who studied 50 dry adult vertebral columns, the above-mentioned incidences were 2%, 4%, and 2%, respectively [21]. Ajay et al found CFCV incidence of 1.4% in the material of 280 dried adult cervical vertebrae [22].…”

“…The congenital fused cervical vertebrae (CFCV), which are usually two and, rarely, more than two in number, constitute a solitary unit that functions as one vertebra [3]. The incidence of CFCV varies between 0.5% [4] and 6.25% [5], whereas the frequency for the fused second and third cervical vertebrae (C2-C3) varies between 0.10% [6] and 1.33% [7]. CFCV usually are asymptomatic until adulthood, when degenerative changes, such as disc hernias and arthritis, are occurring above and below the CFCV’s level; in those cases, it is likely symptoms of nerve root compression will be noticed [8].…”