In particular, vertebral body abnormalities, including wedge-shaped vertebral bodies, anterior beaking with posterior scalloping and platyspondyly, are observed in subjects with multiple sulfatase deficiency, a very severe form of mucopolysaccharidoses due to mutations in the SUMF1 (sulfatase modifying factor 1) gene.28 Here, SUMF1 is linked to Multiple sulfatase deficiency.