Pediatric Orthopedic Surgeons treating Spondylothoracic Dysostosis

SPONDYLOTHORACIC DYSOSTOSIS

 

Spondylothoracic Dysostosis is a condition recognized in newborns.  It occurs by the bones of the spine and ribs not forming correctly and appear misshapen and abnormally joined together.

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Spondylothoracic Dysostosis

Malformations of the spine and ribs are the hallmark of the disorder known as Spondylothoracic Dysostosis. In this condition, the spinal bones do not form properly, leading to their irregular joining and misaligned structure. Furthermore, the posterior (nearest the spine) portion of the ribs is united, giving the rib cage its recognizable “crab” or “fan” look on x-rays. The resulting bone deformities lead those affected to have short, inflexible torsos and necks. As a result, a person with Spondylothoracic Dysostosis has a short torso (dwarfism) but normal arm and leg length. In addition, other signs of Spondylothoracic Dysostosis appear in newborns when they have small diaphragms that cannot fully expand, often causing life-threatening breathing problems.

The diaphragm is a muscle that divides the belly from the thoracic cavity.  With this condition, the diaphragm pushes down and forces the abdomen out as the lungs expand in a constricting chest. Increased pressure in the abdomen can cause a hernia or umbilical hernia. Also, a similar syndrome involving anomalies of the spine and ribs is known as Spondylocostal Dysostosis. Although the two disorders were sometimes combined and occasionally referred to as the Jarcho-Levin syndrome, they are now recognized as separate ailments.

Spondylothoracic Dysostosis Causes

MESP2 gene

A protein that is essential for the formation of vertebrae receives instructions from the MESP2 gene. Specifically, it has a role in somite segmentation, a process that occurs early in the formation of the vertebrae and ribs. Furthermore, the MESP2 gene mutations result in the creation of abnormally short, nonfunctional proteins, or the complete absence of any protein. The spine and ribs can mal form and fuse together in Spondylothoracic Dysostosis when the MESP2 protein is dysfunctional or missing.

Change mutation

An alteration (mutation) in the MESP2 gene results in Spondylothoracic Dysostosis. As an example, most affected individuals have a mutation in this gene, but occasionally individuals with this condition do not, indicating that additional, as-yet-unknown genes may also cause this disorder. Genes include instructions for creating proteins, which are essential for many body functions. The proteins produced by mutated genes are often flawed, ineffective, or nonexistent. Therefore, this may have an impact on a variety of bodily organ systems depending on how the protein operates.

Autosomal recessive inheritance

Autosomal recessive inheritance is the mode of inheritance for Spondylothoracic Dysostosis. Most genetic diseases are caused by a gene being mutated, which can be inherited from either parent. When a person receives two copies of an atypical gene for the same characteristic, one from each parent, recessive genetic diseases result. A person can carry the illness but not exhibit any symptoms if they inherit one normal gene and one disease gene. With each pregnancy, there is a 25% chance that two carrier healthy parents will transfer the mutated gene and result in an afflicted baby.

With each pregnancy, there is a 50% chance that the kid will carry the same gene as one of the parents. A child has a 25% chance of inheriting normal genes from both parents. The degree of risk is the same for both men and women.

Spondylothoracic Dysostosis Symptoms

The first paragraph of this page outlines the major symptoms of Spondylothoracic Dysostosis, but with this condition, doctors find the spine shorter than normal. Most people with STDs have short, straight spines, but then some have an abnormally curved spine. It is not unusual to find an S-shaped (scoliosis) spine; abnormally inwardly curved (lordosis); or abnormally outwardly curved (kyphosis), making the back appear rounder.

The trunk

The physical section called the trunk, which runs from the neck to the abdomen may appear smaller. Furthermore, afflicted people may not reach a normal height and grow not as tall as their peers. A short, immobile neck is possible in those who are affected.

Reduced lung capacity

The lungs of afflicted newborns and youngsters may not develop and function normally due to spine and rib deformity. The lungs can contain less air than they would ordinarily because affected babies and youngsters cannot extend their chests enough. As a result, those who have this illness may have breathing issues and frequently contract respiratory infections. Severe breathing issues have the potential to cause life-threatening issues. Heart failure risk might also rise with decreased lung capacity.

Inguinal hernia

An inguinal hernia is a disorder that causes sections of the large intestine to protrude through a hole in the abdomen.  It also protrudes in the wall opening close to the belly button. Spondylothoracic Dysostosis is associated with an increased chance of having the condition (umbilical hernia).

Spondylothoracic Dysostosis Diagnosis

Our doctors diagnosis this condition through the following:

  • Identification of distinctive symptoms
  • A thorough patient history
  • A comprehensive clinical assessment,
  • And a number of specialist tests

X-rays

X-rays (radiographs) of the spine can reveal the distinctive rib and spine abnormalities that define Spondylothoracic Dysplasia.

Molecular genetic testing

In certain people, molecular genetic testing can confirm a Spondylothoracic Dysplasia diagnosis. Only a diagnostic service at a specialist lab with molecular genetic testing can identify changes in the MESP2 gene.  Additionally, molecular genetic testing cannot validate a diagnosis in cases when this gene is not mutated.

Fetal ultrasound

Fetal ultrasonography works well to diagnose Spondylothoracic Dysplasia during pregnancy. Ultrasound is a great test that allows doctors to see images of the developing fetus. Some of the problems connected with Spondylothoracic dysplasia can appear during fetal ultrasonography.

Spondylothoracic Dysostosis Treatment

Throughout the course of treatment and even after, a team of specialists will need to work together. Pediatricians, orthopedists, cardiologists, pulmonologists, and other medical professionals will systematically and thoroughly plan a  course of treatment for the child. It is advised that afflicted individuals and their families seek genetic and family-wide psychosocial counseling as well. 

Respiratory support

Babies who have trouble breathing may need some form of breathing aid. This may include using machines or devices to help the infant breathe. Some infants may require urgent care requiring continuous hospital monitoring. Surgery is used to repair hernias and antibiotics for infections. With the advent of a Prosthetic Rip, Thoracic VEPTR surgery is beneficial in strengthening the chest and maximizing the growth potential of the lungs. 

VEPTR (Vertical Expandable Prosthetic Titanium Rib)

For the treatment of some breathing conditions in children with STDs, the FDA authorized the Vertical Expandable Prosthetic Titanium Rib (VEPTR) in 2004. With STD the chest, spine, and ribs are severely malformed, which interferes with proper lung growth and respiration. The VEPTR is an implanted, expandable device that aids in separating the ribs and straightening the spine.  This allows the lungs to develop and expand to the proper size to hold adequate air for breathing. As the patient ages, the doctors will adjust the VEPTR length to compensate for the patient’s growth. Ribs are separated from one another on either side of the chest, and VEPTRs are then positioned there for the treatment of Spondylothoracic dysplasia.

For providing cutting-edge pediatric orthopedic care, Medical City Kids Ortho has received recognition. For example, families come from all over the world to consult with our Pediatric Orthopedic specialists. In addition, our sophisticated labs can diagnose very rare conditions such as Spondylothoracic Dysostosis. After determining your child’s health, our care teams collaborate to develop a specialized treatment strategy — tailored to your family’s requirements.

Our recognized pediatric orthopedic specialists are responsible for the treatment of children and the many types of diseases and conditions.  Finally, Medical City Kids Ortho has developed one of the best pediatric imaging systems in the world to monitor and record changes in children’s bodies. We invite you to call our office and make an appointment.

 

Call 214-556-0590 to make an appointment.

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