Traumatic subluxation associated with absent cervical pedicle: case report and review of the literature

Spine
Sung-Jun MoonSoo-Han Kim

Abstract

Case description. To describe a case of traumatic subluxation in association with a congenitally absent cervical pedicle, and review the pertinent medical literature. The congenital absence of a cervical pedicle is a relatively uncommon developmental anomaly that is frequently mistaken for a unilateral facet fracture-dislocation in the context of acute trauma. Because there is little evidence of recovery after surgery, and the symptoms are usually not disabling, surgery is not recommended for most cases. A 62-year-old man presented with severe neck and right shoulder pain after falling. Plain radiographs and computed tomography of the cervical spine showed the typical features of a congenitally absent pedicle at C6 with anterolisthesis of C6 on C7. We performed anterior interbody fusion at C6-C7 because of persistent neck pain and progressive instability. Complete restoration of the C6-C7 subluxation was achieved with resolution of the presenting symptoms. At 18 months follow-up, flexion and extension dynamic radiographs demonstrated good alignment with solid fusion at C6-C7. Although conservative treatment is the primary treatment for this clinical entity, surgery is an alternative option for those patients who fail to achieve...Continue Reading

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Citations

Feb 11, 2014·Acta neurochirurgica·Michael Payer, Enrico Tessitore
Dec 15, 2010·PM & R : the Journal of Injury, Function, and Rehabilitation·Ivan Chernev
Nov 18, 2010·Journal of Korean Neurosurgical Society·Kyo-Chang SongSang-Bok Lee
Aug 15, 2009·Clinical Orthopaedics and Related Research·John R Fowler, Ray A Moyer

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