Butterfly Vertebrae Meaning, Symptoms, Causes, Treatment

Butterfly Vertebrae

Butterfly Vertebrae Meaning

Butterfly vertebrae are rare spinal anomalies. It happens when there is persistent notochordal tissue between the lateral vertebral body halves, causing a fissure in the middle and preventing the lateral halves of the vertebral body from fusing. The two half-vertebrae seem like the butterfly’s wings when viewed on a frontal X-ray, but the Processus Spinosus symbolizes the butterfly’s body.

This abnormality is most commonly found in the thoracic or lumbar spine segments. This disorder is so named because the afflicted vertebra has a broad body, like a butterfly. In most cases, the vertebral bodies located above and below the butterfly vertebra show concavities along the neighboring endplates. These concavities serve as an adaptation to the changed intervertebral discs located on either side.

The butterfly vertebra was originally reported in the year 1844. It is also referred to as the cleft vertebra, the sagittal cleft vertebra, the anterior rachischisis, the anterior Somatoschisis, and the anterior spina bifida. It commonly manifests in the lumbar spine and can occur as an isolated anomaly or as part of a syndrome of abnormal deformities affecting other skeletal regions and/or other systems, most notably the gastrointestinal, central nervous systems, and genito-urinary.  This condition is often linked to kyphoscoliosis.

Butterfly Vertebrae Symptoms

This abnormality is typically asymptomatic despite being uncommon. Butterfly vertebrae are unusual in the general population. It is linked to conditions like Pfeiffer, Jarcho-Levin, Crousen, and Alagille. Another possible relationship is possessing an anterior spina bifida, either with or without an anterior meningocele.

Normal-height butterfly vertebrae do not always cause the spinal column’s axis to deviate. These are typically present in the thoracic spine but can also manifest in the lumbar region.

There are also reports linking butterfly vertebrae to low back pain. Their rarity makes them susceptible to being mislabeled as something else. Because many of the symptoms are first discovered by accident, the true incidence as well as the complete range of illnesses that are associated with it are unclear.

Although patients typically exhibit no symptoms, this deformity may affect spinal biomechanics, leading to atypical back discomfort or an increased risk of disc herniation, and is therefore often discovered inadvertently.

Butterfly Vertebrae

Butterfly Vertebrae Causes

This problem is caused by separate bilateral ossification centers that are unable to join, a process that should begin around the seventh week of pregnancy and last until the 25th week. The main characteristic of this disorder is central aberrant ossification of the vertebral body, which most likely occurs after the partial fusion of two cartilaginous centers with hypoplasia at the junctional location. A developmental flaw that results in the regression of the chorda dorsalis and the separation of the vertebra into its right and left halves is one possible cause of butterfly vertebrae.

Normally, two chondrification centers in the mesenchymal tissue of the somites begin to develop into cartilage, and the somites unite to form a single vertebral body. The intervertebral disc forms from a dense band of mesenchyme that forms at the junction of neighboring somites, situated between the vertebral bodies. As the vertebral body’s two chondrification centers unite, the notochord is “squeezed out” into the intervertebral disc, where it helps create the nucleus pulposus.  The butterfly vertebral malformation comes from the failure of this union of the two vertebral body parts, which is thought to be caused by persisting notochord remnants.

Butterfly Vertebrae Treatment

The primary purpose of physical therapy for this ailment is to restore the patient’s range of motion in his lumbar spine to a level that allows him to do daily functional tasks with little discomfort. The intervention strategy to achieve these objectives is:

  • Using passive mobilization and slump mobilization exercises, increases the mobility of involved soft tissue components (e.g., ligament, nerve, joint capsule, tendon, and muscle).
  • To improve lumbar active stability, it is necessary to increase trunk strength, improve positional awareness, and improve neuromuscular control of lumbar motion, in addition to improving static and dynamic postures.

Therapeutic manipulation of the low back often entails the use of a non-thrust lumbar rotation mobilization approach, with the patient laying on their right side. About 5 minutes are spent stretching into resistance. Although there is evidence that spinal manipulation is effective for treating LBP, there is currently insufficient evidence to conclude which technique is best.

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