Medical Questions > Conditions and Diseases > Orthopedics Forum

Dextroconvex scoliotic deformity

Hello;
A little history... Never had any back pain in my life until 2011.2 yrs ago I hurt my lower back lifting a large box. Lower back CT revealed only a sprain to my lower lumbar area and all vertebra looked normal in the L1 to L5 region. Had a bit of pain but nothing much. It cleared up for the most part. I only had mild back ache from time to time since then.
In April, 2013, I hurt my back at work one day and needed to get x-rays done. "The xrays showed my spine to be curved" I was told, so the Dr. requested a CT of my upper thoracic area. This is what my CT said:

TECHNIQUE:

CT scan of the lower cervical/upper thoracic spine was obtained with coverage from C5-T5 vertebral body level.

FINDINGS:
There is a fusion of the anterior elements of C5- C6 vertebral bodies. Posterior elements have not been well assessed as they have not been completely included in the field of view. There is presumed fusion of the pars interarticulars of C5-C6 vertebral bodies.

C7 vertebral body is normal.
There is a fusion of anterior elements of T3and T4 vertebral body. There is incomplete fusion of the anterior elements of T3 vertebral body with resultant hemi vertebra. There is a fusion of the right-sided pars interarticularis of T3 and T4 vertebral body.

There is a resultant dextroconvex scoliotic deformity.

T5 is normal.

Visualized lung apex are normal.

Pre and paravertebral soft tissues are normal.

IMPRESSION:
Fusion of C5-C6 vertebral body. Fusion of T3-T4 vertebral body with associated T3 hemivertebral body. Findings are presumed secondary to congenital spinal segmentation anomaly. Correlation with prior radiographs is suggested.

Can anyone help me understand this better? Thanks
Did you find this post helpful?
|

User Profile
replied June 15th, 2013
Especially eHealthy
lusher,

I can help you with the terminology:

TECHNIQUE:

CT scan of the lower cervical/upper thoracic spine was obtained with coverage from C5-T5 vertebral body level.

>> A CT scan, or CAT scan, computed axial tomography, is a study which uses x-rays and a computer program to render “cuts” transversely through the body (as if the body was cut into 1-3mm slices, parallel to the floor). With the newer CT machines, 3D images are now possible, so that the radiologist can recreate the bones of the body, and then turn them in space.

This study was done from the fifth cervical vertebra (neck) to the fifth thoracic vertebra (chest).


FINDINGS:

“There is a fusion of the anterior elements of C5- C6 vertebral bodies. “

>> The anterior elements are basically the vertebral bodies. If you do not actually know what the different vertebrae look like, you may want to get some pictures/diagrams of the vertebrae. As they say, a picture is worth a thousand words.

So, you have a fusion of the bodies of the fifth and sixth cervical vertebrae. This is actually fairly rare and is called Klippel-Feil syndrome.



“Posterior elements have not been well assessed as they have not been completely included in the field of view. There is presumed fusion of the pars interarticulars of C5-C6 vertebral bodies.”

>> Unfortunately, the posterior elements (the parts of the vertebrae in the back; the spinous process, pars interarticularis, the lamina) are not included in the study. The radiologist is assuming that the posterior parts of the vertebrae are also fused, as this is the usual case in Klippel-Feil. The pars interarticularis is a set of paired segments in the posterior elements, which make up part of the “ring” of the vertebrae, which go around the spinal cord.



“C7 vertebral body is normal.”

>> The seventh cervical vertebra is normal.




“There is a fusion of anterior elements of T3and T4 vertebral body.”

>> The bodies of the third and fourth thoracic vertebrae are also congenitally fused.




“There is incomplete fusion of the anterior elements of T3 vertebral body with resultant hemi vertebra.”

>> In the third thoracic vertebra there is a specific deformity, whereby the vertebral body is only half formed (a hemivertebra). When a hemivertebra occurs, it is as if a wedge has been placed into the spine, resulting in a “curvature” at that point. You might want to Google "hemivertebra".



“There is a fusion of the right-sided pars interarticularis of T3 and T4 vertebral body.”

>> In the posterior elements of the third and fourth thoracic vertebrae, the pars on the right side is fused. This is a common finding in a hemivertebra. Again, the pars is part of the “ring” of the vertebra, which goes around the spinal cord. So, the right pars of the third is fused to the right pars of the fourth vertebrae.




“There is a resultant dextroconvex scoliotic deformity.”

>> Dextro just means “right”. So, you have a curvature with the convex side (apex) to the right. For your information, sinister means “left”.




“T5 is normal.”

>> The fifth thoracic vertebra is normal.




“Visualized lung apex are normal.”

>> The lungs seen on the study are normal. The part of the lungs which is seen are the very top part, the apex, which is located just under the clavicle (collar bone).



“Pre and paravertebral soft tissues are normal.”

>> The soft tissues around the spine (such as the muscles, tendon, ligaments, etc) are all normal.

“IMPRESSION:
Fusion of C5-C6 vertebral body. Fusion of T3-T4 vertebral body with associated T3 hemivertebral body. Findings are presumed secondary to congenital spinal segmentation anomaly. Correlation with prior radiographs is suggested.”

>> This is just a summary of the findings listed above. There is nothing new here. The radiologist is just suggesting that previous x-rays be looked at, to see if there has been any change in the spine since those films were taken.





As to the significance of the findings, that is something that you need to discuss with your surgeon. All findings on any study have to be correlated with the patient’s history, symptoms, and examination.


It is usualy recommended that any patients who have spinal deformities have their heart, liver, and kidneys checked out. This can be done with ultrasound and/or MRI. This is recommended because the heart, liver, and kidneys form in utero at around the same time as the spine. So, if there are spine deformities, there may also be heart, liver, and/or kidney deformities also.



So, again, you need to discuss your findings with your surgeon. Good luck.
|
Did you find this post helpful?
Must Read
Think you might be experiencing bone loss? Check out this Intro to Osteoporosis and evaluate your risk for developing bone weakness. ...
Although bone mass loss is normal as we age, some people are more at risk of developing osteoporosis than others. Are you at risk? More here....
Do you have severe back pain? Do your bones break frequently or with little pressure? You might be experiencing osteoporosis. Found out more here....