Cervical Spinal Cord Compression in MPS IVA; Clinical Signs In The Absence of MRI Changes.

Cervical spine instability is a well-known complication of mucopolysaccharidosis IVA (Morquio A disease). If left untreated it nearly always results in spinal cord compression  and progressive neurological deterioration. Timely surgery can be not only life-saving but may prevent  irreversible damage to the cervical cord.

MRI scan of the cervical spine can detect early cord compression, allowing surgeons to intervene early. It has become an essential part of monitoring MPS IVA.

In a recent paper, Broomfield and colleagues at the Royal Manchester Children’s Hospital have described their experience of cervical spine surgery in MPS IVA over an eighteen-year period. Their findings of course confirm previously reported experience as above. However, they also include six patients who developed clinical signs of cord compression in the absence of any MRI changes. This is an important observation and a timely message. It underlines the importance of careful clinical examination, as well as the danger of over-reliance on MRI scans.

Here is the full reference with the link to the paper (pdf kindly supplied by Dr Broomfield).

Outcomes from 18 years of cervical spine surgery in MPS IVA; a single centre’s experience. Broomfield, A., Zuberi, K., Mercer, J. et al. Childs Nerv Syst (2018) 34: 1705. 

Author: Ashok Vellodi

I have had a lifelong interest in lysosomal storage disorders. Having recently retired I now have time to pursue my passion for teaching and training of young doctors and scientists, and hopefully instil in them the passion for their patients that is so integral to working in this field.

Leave a Reply

Your email address will not be published.