vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-4-414-421vestim-456Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEРентгенологический фенотип врожденных пороков развития позвонковX-ray genetic phenotype of congenital disease developmentКабакС. Л.KabakS. L.

д-р мед. наук, профессор, заведующий кафедрой

D. Sc. (Med.), Professor, Head of the Department

kabakmorph@gmail.comЗаточнаяВ. В.ZatochnayaV. V.

ст. преподаватель

Senior Lecturer

v.zatochnaya@gmail.comЖижко-МихасевичН. О.Zhizhko-MikhasevichN. O.

врачрентгенолог

Radiologist

nataliamikhasevich@rambler.ruБелорусский государственный медицинский университет, МинскBelarusian State Medical University, MinskРеспубликанский научно-практический центр травматологии и ортопедии, МинскRepublican Scientific and Practical Center of Traumatology and Orthopedics, Minsk201814012019154414421Copyright © Кабак С.Л., Заточная В.В., Жижко-Михасевич Н.О., 20192019Кабак С.Л., Заточная В.В., Жижко-Михасевич Н.О.Kabak S.L., Zatochnaya V.V., Zhizhko-Mikhasevich N.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/456

В статье дано описание радиологического фенотипа пороков развития позвонков при врожденном сколиозе и обсуждены возможные механизмы морфогенеза некоторых из этих аномалий. Приведено 5 случаев полного или частичного расщепления в сагиттальной плоскости тела одного из грудных позвонков – бабочковидного. Передняя расщелина сочеталась с другими пороками развития осевого скелета: конкресценцией тел, дуг и отростков позвонков, правосторонним или левосторонним полупозвонком, spina bifida posterior. У всех пациентов имелась сколиотическая деформация позвоночника с правосторонней или левосторонней дугой искривления. У плодов человека первого триместра гестации без видимых пороков развития в хрящевой закладке тела грудных позвонков выявлено присутствие от одного до трех центров окостенения, а у плода с экзэнцефалией – отсутствие зачатка межпозвонкового диска между телами С2 и С3. По данным литературы, этиология врожденных пороков развития позвонков мультифакториальная. В патогенезе данной патологии имеет значение нарушение локального кровотока из-за аномального хода межсегментарных артерий и, как следствие, полное или частичное неразделение смежных сомитов или ассоциированной с ними мезенхимы. Возможной причиной передней расщелины, по мнению авторов, может быть несвоевременная инволюция сосудистых каналов, врастание которых в хрящевую закладку тела позвонка предшествует появлению в ней центра окостенения. Обнаруженное нами отсутствие на значительном протяжении межпозвоночного диска между хрящевыми закладками тел С2 и С3 у плода человека с экзенцефалией свидетельствует о тесной взаимосвязи развития осевого скелета и нервной трубки.

The aim of the study is to describe the radiological phenotype of vertebral malformations in congenital scoliosis and to discuss the possible mechanisms of morphogenesis of some of these anomalies. The article describes 5 cases of complete or partial splitting in the sagittal plane of the body of one of the thoracic vertebrae (butterfly-shaped vertebra). The anterior vertebral cleft was combined with other congenital vertebral anomalies: block of vertebra, hemivertebrae, spina bifida posterior. All patients had scoliosis with right-sided or left-sided curves. In the human fetuses of the first trimester of gestation without visible malformations in the cartilaginous anlages of the thoracic vertebral bodies we revealed the presence of one o three centers of ossification, and in the fetus with exensephaly – the lack of the intervertebral disc anlage between the bodies C2-C3. According to the published data, the etiology of congenital vertebral anomalies is multifactorial. In the pathogenesis of this pathology, there is a violation of local blood flow due to the anomalous course of intersegmental arteries and as a consequence – a complete or partial separation of adjacent somites or associated mesenchyme. According to the published data, a possible cause of the anterior cleft may be untimely an involution of cartilage canals, the growth of which in the cartilaginous anlage of the vertebral body precedes the appearance of the ossification center. The absence of the intervertebral disk at a considerable length between the cartilaginous anlages of bodies 2 and 3 of the cervical vertebrae in the human fetus with exencephaly indicates a close relationship between the axial skeleton and the neural tube.

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The authors declare that there are no conflicts of interest present.