Clinical Case Vignettes
Congenital
block vertebrae in lumbar spine
Ankur
Nandan Varshney1*, Nilesh Kumar2, Nand Kumar
Singh3
Author Affiliations
1 Junior resident, Division of
Rheumatology, Department of General Medicine, Institute of Medical Sciences
(IMS), Banaras Hindu University (BHU), Varanasi, India
2 Senior resident, Division of Rheumatology,
Department of General Medicine, IMS, BHU, Varanasi, India
3 Professor of Medicine and Head, Division of
Rheumatology, Department of General Medicine, IMS, BHU, Varanasi, India
* Correspondence: Dr. Ankur Nandan Varshney
IJRCI. 2013;1(1):V3
Received: 20 April 2013, Accepted: 10 May 2013,
Published: 13 May 2013
© IJRCI
A 34-year-old female visited our rheumatology clinic with the complaint of non-inflammatory back pain that usually occurred on bending down and radiated to bilateral lower limbs. A diagnosis of compressive neuropathy was suspected and an initially performed digital X-ray of lumbar spine revealed a rare congenital anomaly termed as ‘Congenital block vertebrae’ in the lumbar spine (Fig 1).
Block vertebrae, a congenital anomaly, occurs due to improper segmentation of vertebral column during fetal development. Improper segmentation leads to fusion of adjacent vertebrae through their inter-vertebral disc. The most common site of this deformity is cervical spine and the lumbar vertebral involvement is rare. The disco-vertebral articulation is always involved and depending on the degree of involvement, the presenting complaints could be either neurological due to the compression of nerve roots or scoliosis due to the vertebral deformity.
Fig 1: Lateral view of the X-ray
of lumbar spine showing fusion of L3-L4 vertebrae resulting in congenital block
vertebrae
Competing interests
The
authors declare that they have no competing interests.