Platyspondyly is a generalized vetebra plana and thus corresponds to the reduction in height of vertebral bodies, as it can be acquired or congenital. The acquired form is usually due to herniated discs or tumors, and the congenital form is usually due to dysplasia. Therapy is often conservative using a brace.
What is platyspondyly?
The bony elements of the spine are called vertebrae and have a characteristic shape and height. Vetebra plana is the term used to describe a pathologic flattening that affects a solitary vertebral body. On the other hand, if several vertebrae of the spine show flattening and thus a reduction in height, it is called platyspondyly. This is a generalized vetebra plana, which can be either congenital or acquired. Platyspondyly is not a disease in itself, but rather a symptom. The congenital forms occur in the context of so-called skeletal dysplasias and manifest as a wide variety of symptom complexes. The acquired form of generalized vertebral flattening is often associated with an enlargement of the intervertebral discs and can thus be due, for example, to a herniated disc and the resulting increase in volume of the intervertebral discs. Platyspondyly is sometimes also referred to as generalized flat vertebrae or flat vertebrae. The therapeutic steps differ greatly in the acquired and congenital forms of the phenomenon. Therefore, causal research in platyspondyly has high clinical relevance.
Causes
Platyspondyly may present as a congenital phenomenon in the context of different symptom complexes, which are usually skeletal dysplasias. If the manifestation occurs immediately after birth or while still in infancy, the primary causes may be achondroplasias, diastrophic dysplasias, or thanatophoric dysplasias. In addition, the congenital form is characterized by cogenital spondyloepiphyseal dysplasia and hypophosphatasia as well as syndromes such as Goldblatt or Cushing syndrome. Flat vertebrae manifest particularly markedly in infancy in the setting of metatrophic and pondyloepimetaphyseal dysplasias. In hypothyroidism, the flattening develops into severe manifestation only over the years. If the cause of the flattening is congenital but the manifestation occurs in older children, other conditions may be primary. These conditions include osteogenesis imperfecta, mucopolysaccharidosis type IV, homocystinuria, and chondrodystrophy. In addition, polytopic dysostosis, Dreyfus or Pyle syndrome, and progressive pseudorheumatoid or arthropathy may be associated with flat vertebral manifestations in older children. Nongeneralized but multiple flat vertebrae also occur in knee dysplasia, arthro-ophthalmopathy-Stickler syndrome, dysosteosclerosis, and Dyggve-Melchior-Clausen syndrome. Acquired forms of platyspondyly are most commonly associated with tumor metastases, along with disc herniations. Vertebral flattening manifests primarily in the middle or lower thoracic spine due to increased forces in this area. When platyspondyly affects the lumbar spine, it is often associated with kyphosis. The lumbar spine assumes a convex curvature in kyphosis. Chronic pain, sleep disorders, organ dysfunction and sensory disturbances are conceivable accompanying symptoms of this phenomenon. In individual cases, psychological problems such as depression also occur. Patients with platyspondyly also often suffer from postural weaknesses regardless of the triggering disease. Depending on the localization of the generalized flattening, neurological deficits such as motor disorders may also occur. The further symptoms depend strongly on the cause in the individual case. For example, congenital platyspondyly is usually accompanied by multiple dysplasias of the skeleton, such as those present in the syndromes and dysplasia complex mentioned above. The acquired form due to tumor symptomatology may be characterized by a progressive course, which in individual cases may progress to paraplegia.
Diseases with this symptom
- Cushing_syndrome
- Achondroplasia
- Metastases
- Chronic pain
- Heat stroke
- Pyle syndrome
- Paraplegia
- Brittle bone disease
- Pycnodysostosis
- Morquio’s disease
- Knee dysplasia
- Skeletal dysplasia
Diagnosis and course
In the diagnosis, the physician is helped primarily by X-ray imaging. The vertebral flattening is documented by X-ray and the underlying disease is determined differential diagnosis. In order to determine the cause, the time of onset and the family history of underlying diseases are of particular relevance. In addition, platyspondyly must be differentiated from isolated height loss due to inflammatory processes by means of imaging. The prognosis for patients with platyspondyly depends on the underlying cause. Tumor-associated vertebral flattening tends to have an unfavorable prognosis. In the setting of disc herniation, the prognosis is more favorable.
Complications
Platyspondyly develops primarily in the context of congenital skeletal deformities. Atrophy of the vertebral bodies causes deformities of the spine. Affected persons suffer from severe pain and sleep disturbances as a result, as well as from respiratory problems. In addition, there are also frequent disturbances of individual organs that lie in anatomical proximity to the spinal column. Furthermore, the spinal nerves can also be affected, resulting in symptoms similar to those of a herniated disc. Thus, motor and sensory disturbances are also conceivable. Achondroplasia is one of the most common causes of platyspondyly. Affected persons are usually of short stature and have shortened arms and legs, so that the quality of life is severely restricted. In addition, motor skills develop very slowly, but a reduction in intelligence is not observed. In addition, the disease often leads to colds and poor posture. In addition, there are paralyses and hydrocephalus. The disease is genetically inherited, so that the children can also suffer from achondroplasia. Another disease of the bones that can be associated with platyspondyly is brittle bone disease (osteogenesis imperfecta). Affected individuals have severely brittle bones that tend to fracture with even the slightest vibration. In addition, patients are usually confined to a wheelchair, so their quality of life is severely impaired.
When should you see a doctor?
Platyspondyly always requires treatment. If positive knowledge is obtained, a specialist should be consulted immediately to initiate proper treatment. It is questionable, however, whether a visit to a physician is necessary even if it is merely suspected. This depends on the individual case and can therefore not be answered in a general way. In principle, however, an orientation to the degree of suspicion is helpful. Anyone who assumes on the basis of tangible facts that he or she is suffering from platyspondylitis should consult an orthopedist. This is because a reliable diagnosis can only be made by a specialist. Even a general practitioner will not be able to make a definitive diagnosis, as he or she does not have the technical equipment (e.g. X-ray machine) necessary to make a diagnosis. Inaction leads to ignorance and thus uncertainty. Tangible facts are present when concrete symptoms of platyspondyly appear. Anyone who has a suspicion without being able to substantiate it with concrete circumstances can first consult a family doctor. He can confirm or refute the suspicion. If necessary, he will refer to an orthopedist or other specialists.
Treatment and therapy
Treatment of platyspondyly depends on the actual cause of the vertebral changes. Genetic causes cannot be eliminated. Therefore, in the context of familial dysplasia, platyspondyly can only be treated symptomatically. This symptomatic treatment may correspond, for example, to therapy by means of a clinical corset. Such therapeutic steps belong to the conservative measures and can bring about a reduction of the symptoms in both cases of congenital and acquired platyspondyly. In both cases, sufficient pain therapy can be administered by means of medication. In some cases opiate patches are also used. Thus, the symptomatic therapy of platyspondyly is divided into internal measures of pain therapy and external stabilization measures, which usually inform a permanent therapy. In acute cases, bed rest can alleviate acute symptoms. In acquired forms of platyspondyly caused by tumor metastases, surgical treatment is performed.The affected areas are cleared out and vertebral body replacements are inserted. Depending on the accompanying symptoms, physiotherapy may be used to counteract postural weaknesses or motor deficits in individual cases.
Outlook and prognosis
In platyspondyly, there is primarily a severe malalignment and curvature of the vertebrae in the patient. Due to the curvature of the vertebrae, the spine is also stressed, so that severe pain occurs in this case. This pain occurs mainly during sleep, so that it is not uncommon for the patient to suffer from sleep disturbances. These have a negative effect on the patient’s state of mind and physical condition and can greatly reduce the quality of life. Most people with platyspondyly are underweight. Due to this symptom, life becomes equally limited. Due to platyspondyly, patients often suffer from flu and colds and the symptom of hydrocephalus. Often, platyspondyly also occurs together with brittle bone disease and can put additional strain on the patient’s life. In this case, affected persons are dependent on the help of other people or on the use of crutches and wheelchairs. There is no complete cure for platyspondyly. However, the symptoms can be limited so that everyday life is made bearable for the patient. Physiotherapies are particularly helpful here.
Prevention
Acquired platyspondylia due to disc herniation can be prevented by steps such as weight loss, exercise, postural training, and proper lifting and carrying. No promising preventive measures exist for platyspondylia in the setting of genetic dysplasias and syndromes.
Here’s what you can do yourself
In accordance with the fact that there is no cure for the congenital form of this spinal dysplasia, self-help measures are also designed purely to treat the symptoms and slightly improve individual living conditions. Decisive factors are the sequelae of the platyspondyly as well as the further physical circumstances of the affected person. This is also true for people with acquired platyspondyly. In their case, however, the situation is easier to survey due to the lack of existing symptom complexes, and physiotherapeutic measures in particular are more promising, because they can be carried out without being restricted by further symptoms and abnormal growths. Thus, physiotherapeutic measures can be taken by affected persons, which can be managed within their physical limitations. In this way, further deterioration in posture can be counteracted. Those affected can also learn certain movement sequences that cause less pain or are more efficient. Such physiotherapeutic measures usually take the form of long-term therapy. Maintaining physical abilities can also be supplemented by exercises at home. Since platyspondyly leads to pain and sleep problems, those affected can find relief here by means of a wide variety of measures. Relaxing baths, using essential oils, or consuming plant-based pain-relieving substances can provide relief. In acute episodes of pain, equally acute bed rest usually helps.
