Cervical Spine Anomalies in Fetal Alcohol Syndrome

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Abstract
Cases (50) of well-documented fetal alcohol syndrome were reviewed with the intent of describing the cervical vertebral anomalies. Cases (38) had adequately detailed X-ray examination to be included in this study. Of these, 19 or 53% showed congenital fusion of .gtoreq. 2 cervical vertebrae. The associated findings were minor anomalies on the i.v. pyelogram (IVP) in 3 of 18 IVP done, mild to moderate microcephaly in 53% and significant congenital heart anomalies in 41%. Although the vertebral anomalies bear a resemblance to the Klippel Feil syndrome, it is thought that the 2 syndromes are separate. The patterns of occurrence of the vertebral anomalies are different in the 2 groups, and the visceral expression of the disorder is also different, the major visceral anomaly in the Klippel Feil syndrome being in the genitourinary system and that in the fetal alcohol syndrome being in the cardiovascular system. The patterns, however, are close enough to imply a teratogenic event as the etiology in the Klippel Feil group. The occurrence of neck fusion in the fetal alcohol syndrome is common enough for it to be used in making the diagnosis.

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