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NEUROIMAGE
Year : 2016  |  Volume : 64  |  Issue : 1  |  Page : 189-190

Congenital absence of a cervical spine pedicle


Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy

Date of Web Publication11-Jan-2016

Correspondence Address:
Paolo Perrini
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Via Paradisa, 2-56124, Pisa
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.173669

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How to cite this article:
Perrini P, Montemurro N. Congenital absence of a cervical spine pedicle. Neurol India 2016;64:189-90

How to cite this URL:
Perrini P, Montemurro N. Congenital absence of a cervical spine pedicle. Neurol India [serial online] 2016 [cited 2019 Aug 24];64:189-90. Available from: http://www.neurologyindia.com/text.asp?2016/64/1/189/173669


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.[1],[2],[3] 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.[2],[3] 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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  References Top

1.
Dimitrov DF, Bronec PR, Friedman AH. Congenitally absent C-7 pedicle presenting as a jumped locked facet. Case illustration. J Neurosurg 2003;99(Suppl 2):239. Fowler JR, Moyer RA. Case report: Absent C6 cervical pedicle in a collegiate football player. Clin Orthop Relat Res 2010;468:1693-6. Taguchi Y, Matsuzawa M, Ye JM, Uzura M, Watanabe H, Hayakawa M. Posttraumatic cervical epidural hematoma associated with congenital absence of a cervical spine pedicle: Case report and literature review. J Trauma 2001;51:579-82.  Back to cited text no. 1
    


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