Skip to main content

Congenital absence of a cervical spine pedicle: clinical and radiologic findings.

Publication ,  Journal Article
Wiener, MD; Martinez, S; Forsberg, DA
Published in: AJR Am J Roentgenol
November 1990

Congenital absence of a cervical pedicle is an unusual disorder with potentially confusing clinical and radiologic manifestations. A review of the previously reported 42 cases as well as 13 new cases is presented. Congenital absence of a cervical pedicle was an incidental finding in 10 of the 55 total patients (age range, 3-65 years; mean 31 years). The remainder presented with an array of symptoms; the most common was cervical pain (31 patients), often after trauma (19/31). Neurologic examination was normal in the majority (65%) of patients. The most common neurologic finding, in an additional 19% of patients, was isolated diminished sensation in an upper extremity. Imaging included conventional radiographs, tomograms, myelograms, and CT. The typical radiologic triad of findings included (1) the false appearance of an enlarged neural foramen owing to the absent pedicle; (2) a dysplastic, dorsally displaced ipsilateral articular pillar and lamina; and (3) a dysplastic ipsilateral transverse process. The spectrum of this disorder also included absence of the ipsilateral pillar in four of 55 patients and absence of the entire ipsilateral neural arch in five of 55 patients. Other osseous anomalies were present in 28 (51%) of 55 cases. In 10 of 55 cases, initial misdiagnosis resulted in inappropriate therapy, with a poor clinical outcome after therapy in three cases. Conservative therapy was the only successful management in all cases in which follow-up information was available, with the exception of one patient who had partial improvement after surgery. Careful analysis of radiologic images and knowledge of the specific findings of absent cervical pedicle should decrease the potential for misdiagnosis and inappropriate, potentially harmful therapy.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

November 1990

Volume

155

Issue

5

Start / End Page

1037 / 1041

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Myelography
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diagnostic Imaging
  • Child, Preschool
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wiener, M. D., Martinez, S., & Forsberg, D. A. (1990). Congenital absence of a cervical spine pedicle: clinical and radiologic findings. AJR Am J Roentgenol, 155(5), 1037–1041. https://doi.org/10.2214/ajr.155.5.2120932
Wiener, M. D., S. Martinez, and D. A. Forsberg. “Congenital absence of a cervical spine pedicle: clinical and radiologic findings.AJR Am J Roentgenol 155, no. 5 (November 1990): 1037–41. https://doi.org/10.2214/ajr.155.5.2120932.
Wiener MD, Martinez S, Forsberg DA. Congenital absence of a cervical spine pedicle: clinical and radiologic findings. AJR Am J Roentgenol. 1990 Nov;155(5):1037–41.
Wiener, M. D., et al. “Congenital absence of a cervical spine pedicle: clinical and radiologic findings.AJR Am J Roentgenol, vol. 155, no. 5, Nov. 1990, pp. 1037–41. Pubmed, doi:10.2214/ajr.155.5.2120932.
Wiener MD, Martinez S, Forsberg DA. Congenital absence of a cervical spine pedicle: clinical and radiologic findings. AJR Am J Roentgenol. 1990 Nov;155(5):1037–1041.

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

November 1990

Volume

155

Issue

5

Start / End Page

1037 / 1041

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Myelography
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diagnostic Imaging
  • Child, Preschool