Cervical Fusion for Absent Pedicle Syndrome Manifesting with Myelopathy.


Journal Article

BACKGROUND: Absent congenital pedicle syndrome is a posterior arch defect characterized by numerous congenital and mechanical abnormalities that result from disconnection of the anterior and posterior columns of the spinal canal. Absent congenital pedicle syndrome is a rare anomaly that is most commonly diagnosed incidentally, after evaluation of minor trauma, or after complaints of chronic neck pain. We report a case of absent congenital pedicle syndrome in a patient who presented with myelopathy and lower extremity weakness and review the literature on the surgical management of this entity. CASE DESCRIPTION: A 32-year-old woman with a history of systemic lupus erythematosus presented to the Neurosurgery Service with progressive weakness in her upper and lower extremities, clonus, and hyperreflexia. Magnetic resonance imaging revealed congenital absence of the pedicles of C2, C3, C4, C5, and C6 with a congenitally narrow canal at C4-5. The patient underwent a staged anterior and posterior cervical decompression and fusion. She was placed in a halo after surgery; at the 1-year follow-up, she was ambulatory with demonstrated improvement in weakness and fusion of her cervical spine. CONCLUSIONS: Absent congenital pedicle syndrome is rare, and most reported cases were treated conservatively. Surgical management is reserved for patients with myelopathy or instability.

Full Text

Duke Authors

Cited Authors

  • Goodwin, CR; Desai, A; Khattab, MH; Elder, BD; Bydon, A; Wolinsky, J-P

Published Date

  • February 2016

Published In

Volume / Issue

  • 86 /

Start / End Page

  • 515.e17 - 515.e22

PubMed ID

  • 26386456

Pubmed Central ID

  • 26386456

Electronic International Standard Serial Number (EISSN)

  • 1878-8769

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2015.09.017


  • eng

Conference Location

  • United States