What causes butterfly vertebra in the spine on anteroposterior radiograph?
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Butterfly vertebra is a rare congenital anomaly characterized by a midline sagittal cleft in the vertebral body, resulting from failure of fusion of the lateral halves during embryonic development, typically between the third and sixth weeks of gestation; it is usually asymptomatic but may be associated with spinal deformities or syndromic conditions and is most common in the thoracic or lumbar spine.
Why is it called so?:
The name derives from the characteristic butterfly-like configuration of the vertebral body on anteroposterior radiograph, where the two symmetrical lateral halves resemble open butterfly wings separated by a central cleft.
Pathophysiology:
The vertebral body forms from fusion of bilateral sclerotomes derived from somites; failure of midline fusion leaves a persistent sagittal cleft often filled with fibrous, cartilaginous, or notochordal tissue, leading to sclerotic lateral margins and a funnel-shaped appearance with wedge deformity on lateral view.
Alternative names: Sagittal cleft vertebra
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