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Platyspondyly is defined as a reduction in vertebral body height (flattening) across one or more spinal levels, often associated with widening of the vertebral bodies in the anteroposterior direction.
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Radiological Features:
| View/Modality | Radiographic Findings |
|---|---|
| Lateral spine X-ray | Flattened vertebral bodies (“pancake” or “wafer-thin” vertebrae) |
| AP spine X-ray | May show widening of vertebral bodies |
| MRI | Helps evaluate associated spinal canal stenosis or cord compression |
| CT | Useful for bony detailing in complex dysplasias |
(A and B) Pseudoachondroplasia. Spine radiograph in two patients. 2 year old girl (A) showing severe platyspondyly with anterior tongue-like projections (arrows); mimicking MPS IV. Seven year old girl showing more pronounced projections (arrows in B). L1 vertebral body has been marked in yellow for diagrammatic representation of morphology|
Gabra P, Jana M, Naranje P, et al. Spine radiograph in dysplasias: A pictorial essay. Indian Journal of Radiology and Imaging - New Series/Indian Journal of Radiology and Imaging/Indian Journal of Radiology & Imaging. 2020;30(04):436-447. doi:10.4103/ijri.ijri_395_20
Types of Platyspondyly
| Pattern | Description |
|---|---|
| Generalized | Involves the entire spine (e.g., ‣ ) |
| Localized | Confined to a few levels (e.g., trauma, infection, metastasis) |
| With anterior beaking | Common in MPS and Morquio syndrome |
| With vertebral clefts | Central depression or coronal clefting of vertebrae (seen in CDP) |
Skeletal Dysplasias
| Condition | Additional Features |
|---|---|
| ‣ | Short trunk dwarfism, delayed epiphyseal ossification |
| ‣ (mild form) | Narrowing interpedicular distance, rhizomelia |
| ‣ | Micromelia, cloverleaf skull, narrow thorax |
| ‣ | Irregular metaphyses, genu varum |
Storage Disorders
| Condition | Clues |
|---|---|
| ‣ (MPS I, II) | Dysostosis multiplex, anterior beaking |
| GM1 gangliosidosis | CNS symptoms + skeletal dysplasia |
| Mucolipidosis II/III | Similar to MPS but with elevated lysosomal enzymes |
Metabolic/Other
| Condition | Features |
|---|---|
| ‣ | Osteopenia, fractures, wormian bones |
| ‣ | Poor mineralization, bowed limbs, low ALP |
| ‣ | Platyspondyly + metaphyseal flaring |
| ‣ | Epiphyseal irregularities + mild platyspondyly |
Acquired Causes
| Condition | Clues |
|---|---|
| Trauma (burst fracture) | Localized vertebral body collapse |
| Osteoporosis | Flattened vertebrae in older patients |
| Leukemia/lymphoma | Vertebral collapse due to infiltration |
| Infections (e.g., TB) | Gibbus deformity, paravertebral abscesses |
| Feature | Importance |
|---|---|
| Short trunk dwarfism | Seen in many dysplasias with generalized platyspondyly |
| Neurological symptoms | May arise from spinal canal narrowing or kyphoscoliosis |
| Progressive deformity | Worsening spinal curvature in growing children |