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• W3148873606 abstract "Analysis of the individual components of the vertebrae permits the radiologist to identify and understand the fundamental physio-pathologic growth mechanisms affecting shape, size and architecture which operated during development. The achievement of this goal is facilitated by systematically paying attention to changes of the vertebral end-plates, anterior and posterior aspects of the vertebral body, the vertebral rim, neurocentral junction and interpedicular distance. The dynamic changes noted in followup studies of the spine in certain dysplasias may reveal the developmental history of the vertebral complex. The dimension of time is an important factor, which the radiologist has a unique opportunity to exploit. Vertebral configuration permits radiological analysis and diagnosis. The tendency when describing spinal dysplasias is to emphasize the growth disturbances of the cartilaginous end-plates of the vertebral body, while neglecting the other components of the vertebra. Each element (the vertebral body, both end-plates and the neural arch) has its own intrinsic growth properties. However, growth and development of the various components of the vertebrae are interdependent and cannot be dissociated. The individual vertebra is an anatomical structure with both static and dynamic functions. Much can be learned about the whole vertebral complex by studying the aberrant growth and development of the dysplastic vertebra. The radiologist can study only those developmental phases which can be visualized on the radiograph, i.e. the ossification but not the chondrogenetic phase. By using the important dimension of time, the radiologist can achieve some retrospective understanding. Any change in the vertebral complex from infancy to adult life is a dynamic continuum. The abnormal morphologic configuration and size of a single or a group of vertebrae is the result of reactive responses to many factors and forces. These may be grouped under several headings: intrinsic, constitutional, dysplastic factors; extrinsic forces, i.e. weight-bearing, muscle-tendon activity; metabolic and endocrine factors. The fundamental mechanism of vertebral dysplasias is a disturbance in coordination of the various processes of bone growth and formation. Therefore, it is important to consider the overall changes produced by both enchondral and periosteal vertebral growth, rather than those of enchondral growth alone. The purpose of this paper is to point out the growth behaviour of the components of the vertebral complex in some dysplastic conditions. VERTICAL GROWTH (END-PLATES) According to Schmorl (1928), the longitudinal growth of the vertebral body takes place by enchondral development through the epiphyseal endplates. Bick and Coppel (1950) have shown that the body of the human vertebral grows like the diaphysis of a long bone with true proximal and distal epiphyseal plates. Furthermore, the body of the vertebra is subject to the same deforming factors which influence the growth of long bones. Therefore, the same pathologic conditions which affect the growing epiphyseal plates of long bones may affect the vertebrae. Growth of the vertebral body in the vertical plane or height takes place equally in the superior and inferior cartilaginous end-plates (Schmorl 1928; Knutsson 1961; Bick and Coppel, 1950), which play the dominant role in vertebral growth. A defect in the end-plates of the vertebral body has a greater impact in producing deformity than a defect in the periosteal growth potential. In tubular bones a delay in enchondral growth with continuing periosteal growth results in the production of short thick bones with flaring ends. In vertebral dysplasias this dual combination produces an effect on vertical, sagittal and transverse growth resulting in flattened vertebral bodies. Platyspondyly (flat vertebrae) is not a fully satisfactory term because it refers only to the vertical diameter and fails to emphasize the accompanying defects in other vertebral components and diameters. An adequate description of morphological vertebral changes should include the antero-posterior (sagittal on the lateral view) and transverse diameters (on the A.P. view), defects of the neural arch and the interpedicular distance. Platyspondyly is" @default.
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• W3148873606 date "2008-01-01" @default.
• W3148873606 modified "2023-09-27" @default.
• W3148873606 title "Radiological aspects of the vertebral components of osteochondrodysplasias" @default.
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