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Ludwig K, Seiltgens C, Ibba A, Saran N, Ouellet JA, Glorieux F, Rauch F. Craniocervical abnormalities in osteogenesis imperfecta type V. Osteoporos Int 2022; 33:177-183. [PMID: 34350492 DOI: 10.1007/s00198-021-06088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
UNLABELLED Craniocervical abnormalities in osteogenesis imperfecta (OI) such as basilar invagination or cervical kyphosis can cause severe neurological morbidity. These abnormalities may be more frequent in OI type V compared with other OI subtypes of similar disease severity, underlining the importance of screening in this group. INTRODUCTION Craniocervical abnormalities in osteogenesis imperfecta (OI) can cause severe neurological morbidity. Although radiological cranial base abnormalities in OI have been well described in the literature, there are limited data on these abnormalities in OI type V and their association with clinical sequelae. METHODS A retrospective case series on patients with craniocervical abnormalities in OI type V at our institution. RESULTS Craniocervical abnormalities were present in 7 of 37 patients with OI type V (19%). For 5 patients (age at last follow-up: 5 to 26 years; 2 females), sufficient information was available for inclusion in the case series. All had genetically confirmed OI type V. Age range at diagnosis of the craniocervical abnormality was 1 day to 18 years. Basilar invagination was present in 3 patients; 2 had cervical kyphosis. Dysplasia of upper cervical vertebrae or base of skull was seen in 3 patients. The severity of the craniocervical abnormality did not clearly correlate with the severity of the OI phenotype. Three patients required surgical intervention (ages 7, 11, and 26 years) due to compression of the spinal cord or brainstem. Craniocervical abnormalities were detected incidentally or on screening in 3 patients, and only 2 had significant positive findings on neurological examination. CONCLUSION A variety of craniocervical abnormalities are seen in OI type V including dysplasia of the cervical vertebrae. These cases highlight the importance of screening patients with OI type V with lateral skull and cervical spine x-rays throughout childhood and after skeletal maturity.
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Affiliation(s)
- K Ludwig
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - C Seiltgens
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - A Ibba
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - N Saran
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatric Surgery, McGill University, Montreal, QC, Canada
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
| | - J A Ouellet
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatric Surgery, McGill University, Montreal, QC, Canada
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
| | - F Glorieux
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada
- Department of Pediatrics, McGill University, Montreal, QC, Canada
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
| | - F Rauch
- Shriners Hospitals for Children, 1003 Boulevard Decarie, Montreal, QC, H4A 0A9, Canada.
- Department of Pediatrics, McGill University, Montreal, QC, Canada.
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Carroll RS, Donenfeld P, McGreal C, Franzone JM, Kruse RW, Preedy C, Costa J, Dirnberger DR, Bober MB. Comprehensive pain management strategy for infants with moderate to severe osteogenesis imperfecta in the perinatal period. PAEDIATRIC AND NEONATAL PAIN 2021; 3:156-162. [PMID: 35548555 PMCID: PMC8975205 DOI: 10.1002/pne2.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/15/2022]
Abstract
Osteogenesis imperfecta (OI) is a rare genetic heterogeneous disorder that causes increased bone fragility and recurrent fractures. For infants with OI and diffuse fractures, pain management, which is nuanced and specific for this population, is of the utmost importance to their neonatal care. Through experience at our center, we have developed a standard approach that has been successful in optimizing survival for these infants during this tenuous period. In this paper, we outline our multidisciplinary approach to pain management for infants with moderate to severe OI during the neonatal period, with emphasis on promotion of fracture healing and adequate pain control.
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Affiliation(s)
- Ricki S. Carroll
- Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania USA
- Division of Palliative Medicine Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
- Division of Orthogenetics Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Perri Donenfeld
- Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania USA
- Division of Palliative Medicine Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Cristina McGreal
- Division of Orthogenetics Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Jeanne M. Franzone
- Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania USA
- Neonatal‐Perinatal Medicine Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Richard W. Kruse
- Neonatal‐Perinatal Medicine Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Catherine Preedy
- Department of Orthopaedic Surgery Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Joanna Costa
- Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania USA
- Department of Orthopaedic Surgery Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Daniel R. Dirnberger
- Department of Orthopaedic Surgery Nemours Children’s Hospital Delaware Wilmington Delaware USA
| | - Michael B. Bober
- Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania USA
- Division of Orthogenetics Department of Pediatrics Nemours Children’s Hospital Delaware Wilmington Delaware USA
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