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|Year : 2016 | Volume
| Issue : 1 | Page : 189-190
Congenital absence of a cervical spine pedicle
Paolo Perrini, Nicola Montemurro
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
|Date of Web Publication||11-Jan-2016|
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Via Paradisa, 2-56124, Pisa
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Perrini P, Montemurro N. Congenital absence of a cervical spine pedicle. Neurol India 2016;64:189-90
A 15-year-old boy presented with neck pain after a motor vehicle collision. His neurological examination was unremarkable. The patient had no history of cervical pain prior to the accident. Computed tomography (CT) scan of the cervical spine revealed an enlarged neural foramen extending from C6 to C7 on the right side, suggesting an apparent unilateral C6 jumped locked facet [Figure 1]a. Careful evaluation of the CT scan demonstrated a congenital anomaly characterized by dorsal displacement of the ipsilateral articular pillar [Figure 1]a, arrow] and absence of the right C6 pedicle [Figure 1]b, asterisk], with normal cervical sagittal alignment [Figure 1]c. Three-dimensional CT reconstruction images [Figure 1]d clearly showed the absence of the pedicle, with the false appearance of an enlarged ipsilateral neural foramen and a pseudo-facet dislocation. Accordingly, the patient was managed conservatively, and his symptoms progressively resolved. Absence of a cervical pedicle is a rare developmental anomaly that most commonly affects the C6 level.,, This anomaly can be associated with other bony abnormalities, including spina bifida occulta, absence of ipsilateral neural arch and facet joint as well as laminar fusion., The diagnosis relies on the detection of false appearance of an enlarged neural foramen due to the absent pedicle and a dysplastic dorsally located ipsilateral articular pillar, as our case illustrates. Physicians should be aware of this benign congenital malformation to avoid inappropriate management.
|Figure 1: Computed tomography (CT) scan (a-c) and three-dimensional CT reconstruction images (d) of the cervical spine. CT scan revealed dorsal displacement of the right C6 articular pillar (a, arrow) and absence of the ipsilateral C6 pedicle (b, asterisk). Cervical sagittal alignment was maintained (c)|
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