Department of Anatomy, All India Institute of Medical Sciences Patna, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences Patna, India.
Clin Ter. 2023 Jul-Aug;174(4):313-317. doi: 10.7417/CT.2023.2542.
Here we aim to report the persistent spinous process in the 'pan sacral type' of spina bifida occulta in an asymptomatic male and discuss its clinical significance. The presence of this type of dorsal wall defect with a bony spur attached to it has never been described in the literature to the best of our knowledge after extensive literature search. Our work presents the first anatomic description where the spinous and paraspinous cleft are seen in a sacrum of a live subject.
During a morphometric study of the sacra, normal subject computed tomography imaging (CT) was procured from the Department of Radio-diagnosis. A three-dimensional (3D) image of the sacrum was created using Dicom to Print and Geomagic freeform plus software. A complete dorsal wall defect was observed in a 3D reconstructed sacrum of an adult male. The sacral canal was converted into a groove with a bony spur hanging in the centre. The longitudinal bony spur attached to the lamina was the persistent spinous process.
Such congenital defects are clinically significant for the anaesthetist during caudal epidural block and for orthopaedic surgeons before any surgical procedure. It may be misdiagnosed as an abnormal bony injury on CT. Thus, it is essential to ensure that patients with congenital anomalies are not treated unnecessarily for spinal fractures.
本研究旨在报告一例隐性脊柱裂中“骶骨全裂型”持续性棘突，并讨论其临床意义。据我们所知，在广泛的文献检索后，这种带有骨棘的背侧壁缺损类型在文献中从未被描述过。我们的工作首次对活体骶骨中棘突和棘旁裂进行了解剖描述。
在对骶骨进行形态计量学研究时，从放射科获取了正常受试者的计算机断层扫描（CT）图像。使用 Dicom to Print 和 Geomagic freeform plus 软件创建了骶骨的三维（3D）图像。在一名成年男性的 3D 重建骶骨中观察到完全的背侧壁缺损。骶管变成了一个带有中心悬挂骨棘的槽。附着在椎板上的纵向骨棘是持续性棘突。
此类先天性缺陷对行骶尾部硬膜外阻滞的麻醉师和任何手术前的骨科医生具有重要的临床意义。它可能在 CT 上误诊为异常骨损伤。因此，务必确保对患有先天性异常的患者不进行不必要的脊柱骨折治疗。
