ABSTRACT
We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom serial imaging studies showed the development of multiple vertebral collapse, and communicating superior and inferior Schmorl's nodes creating a longitudinal channel ("tunneling" Schmorl's nodes) through the anterior aspect of T12 to L3 vertebral bodies of her osteoporotic thoracolumbar spine. This was observed after achieving complete remission of the disease and during maintenance therapy. The finding is felt to be secondary to iatrogenic exacerbation of osteoporosis.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Intervertebral Disc Displacement/chemically induced , Magnetic Resonance Imaging , Osteoporosis, Postmenopausal/chemically induced , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Spondylolysis/chemically induced , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Intervertebral Disc Displacement/diagnosis , Lumbar Vertebrae/drug effects , Lumbar Vertebrae/pathology , Osteoporosis, Postmenopausal/diagnosis , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Spondylolysis/diagnosis , Thoracic Vertebrae/drug effects , Thoracic Vertebrae/pathologyABSTRACT
The results of an X-ray investigation of 480 patients suffering from thalidomide embryopathy demonstrate that, beside dysmelia, spinal alterations are an important factor in malformations of the postural and locomotion apparatus. The pattern of malformations consists-according to the frequency of accumulated incidences - of spondylolysis, scoliosis, malformations of the intervertebral disc and dysgenesia of the sacrum. As in the case of extremities this pattern of malformations can only be established by radiological morphology. It necessarily entails alterations of varying functional value. There is no doubt that spinal alterations influence the fate of affected patients in the future.
