Department of Orthopedics, The Hospital Affiliated with the Medical School of Yangzhou University (Taizhou People's Hospital), No. 366, Taihu Road, Taizhou, 225300, Jiangsu Province, China.
Postgraduate School, Dalian Medical University, Dalian, 116000, Liaoning, China.
BMC Musculoskelet Disord. 2020 Jun 22;21(1):392. doi: 10.1186/s12891-020-03433-9.
Butterfly vertebrae are a rare congenital vertebral anomaly. An overlap of this spinal anomaly with other diseases has been reported. However, to the authors' knowledge, the coexistence of butterfly vertebrae and spinal cord injury has not been reported in the literature.
A 42-year-old male was admitted to our emergency department after a motor vehicle accident. His complaint was back pain, and he was unable to move both lower limbs. Upon physical examination, the patient was not ambulatory. Sensory examination revealed the absence of sensation below the T12 level. The strength of the bilateral lower limbs was grade 0. The patient received a radiographic evaluation. The initial diagnosis was T11 fracture with complete paraplegia of the lower limbs. Magnetic resonance imaging (MRI) was then performed. Sagittal MRI demonstrated an isointense lesion on T1-weighted imaging and a high-signal spindle-like lesion on T2-weighted imaging of the spinal cord adjacent to the T11 vertebra. The fat-suppressed sequence also revealed hyperintensities of the cord. There was no evidence of acute injury of the T11 vertebral body except for cuneiform anterior wedging. The patient was ultimately diagnosed with complete paraplegia with a T11 butterfly vertebra. He underwent urgent posterior decompressive and fixation surgery from T10 to T12. His postoperative recovery was uneventful.
The coexistence of a butterfly vertebra with spinal cord injury was reported for the first time. Although butterfly vertebrae may be incidentally detected, it is important to be familiar with their radiographic features to distinguish them from fractures.
蝴蝶椎是一种罕见的先天性脊椎异常。这种脊椎异常与其他疾病的重叠已有报道。然而，据作者所知，蝴蝶椎与脊髓损伤同时存在的情况尚未在文献中报道过。
一名 42 岁男性因车祸被收入我院急诊。他的主诉是背痛，且双下肢无法活动。体格检查时，患者无法行走。感觉检查显示 T12 以下感觉缺失。双下肢肌力为 0 级。患者接受了影像学评估。初步诊断为 T11 骨折伴双下肢完全截瘫。随后进行了磁共振成像（MRI）检查。矢状位 MRI 显示 T11 椎体相邻脊髓在 T1 加权成像上呈等信号病变，在 T2 加权成像上呈高信号梭形病变。脂肪抑制序列也显示脊髓信号增强。除楔形变的 T11 椎体前楔形外，T11 椎体未见急性损伤的证据。最终诊断为 T11 蝴蝶椎所致的完全性截瘫。患者接受了 T10 至 T12 的紧急后路减压固定手术。术后恢复顺利。
首次报道了蝴蝶椎合并脊髓损伤的病例。尽管蝴蝶椎可能是偶然发现的，但熟悉其影像学特征对于将其与骨折区分开来非常重要。
