Anomalous Cervical Spinous Process Leading to Myelopathy

Pithwa, Yogesh Kishorkant

doi:10.1097/brs.0000000000001088

Cited by 5 publications

(3 citation statements)

References 9 publications

(17 reference statements)

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“…Malformations of the posterior arch in the cervical vertebral column are rarely reported in human 3,7,8,[10][11][12] and veterinary medicine. 1,13,14 Axis posterior arch anomalies reported in humans include hypoplasia or aplasia of the lamina, resulting in a free-floating spinous process.…”

Section: Discussionmentioning

confidence: 99%

Axis spinous process malformations are commonly identified in a sample of English Bull Terriers without associated clinical signs

Frias

Decker

Dirrig

et al. 2021

Vet Radiology Ultrasound

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Congenital cervical vertebral malformations (CCVM) have been infrequently reported in veterinary medicine, with limited examples of axis spinous process malformations.The objective of this retrospective cross-sectional study was to describe the radiological characteristics, prevalence, and clinical relevance of a characteristic axis vertebral malformation in a sample of English Bull Terriers (EBTs). Medical records and diagnostic imaging studies of the cervical vertebral column of EBTs presenting for any reason were reviewed and described. Based on evaluation of the images, EBTs were divided in two groups; axis spinous process malformation and normal cases. Referring veterinary surgeons were contacted for long-term follow-up information. A total of 27 cervical radiographs, 23 CT, and nine MRI studies from 53 EBTs were reviewed. An axis spinous process malformation, characterized by a linear defect of varying length along the base of the spinous process, was identified in 22 of 53 EBTs (41.5%). There was no significant difference in age, body weight, or sex (P < .05) between EBTs with and without the malformation. No traumatic causes or clinical signs were identified in EBTs with the malformation that could be directly attributed to it. To the authors' knowledge, this is the first report of a malformation of the axis spinous process in a sample of EBTs. The malformation was not associated with clinical signs and should not be misinterpreted as a traumatic vertebral fracture or other pathology. K E Y W O R D Scervical, posterior arch defect, vertebral anomaly, vertebral congenital defect INTRODUCTIONCongenital cervical vertebral malformations (CCVMs) are infrequently reported in human and veterinary medicine. [1][2][3][4] Although CCVMs are considered to have a low prevalence in dogs, vertebral malformations commonly occur without associated neurological signs. 2,5,6 The true prevalence of CCVMs is therefore unknown and possibly underestimated. 2 Abbreviations: CCVM, congenital cervical vertebral malformations; EBT, English Bull Terrier; STIR, short tau inversion recovery. In human medicine, congenital malformations affecting the axis have been classified as defects of atlantoaxial segmentation, dens dysplasia, os odontoideum, hypoplasia and aplasia, and segmentation failure of the axis and the C3 vertebra. 2,7 Congenital malformations of the posterior elements or dorsal arch of the axis are extremely rare. 7,8 A recent study describing the clinical characteristics of dogs with CCVM included two neurologically abnormal dogs with an absence of the lamina of the axis and a cleft at the level of the dorsal arch of the atlas. 1No studies have yet focused on vertebral malformations of the lamina and spinous process of the axis in dogs. At the authors' institution, a

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Section: Discussionmentioning

confidence: 99%

Axis spinous process malformations are commonly identified in a sample of English Bull Terriers without associated clinical signs

Frias

Decker

Dirrig

et al. 2021

Vet Radiology Ultrasound

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“…Here, the patient perceived his symptoms for the first time in his 60s. These C2 anomalies are treated by removing the anomalous spinous process 9,10) and undergoing fusion surgery in cases involving instability between vertebrae 4,5) . These surgical outcomes are usually satisfactory.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

Cervical Myelopathy Caused by Invagination of Floating Anomalous C2 and C3 Laminae in the Spinal Canal

Nakashima

Otsuki

Shimizu

et al. 2020

Spine Surg Relat Res

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“…Common lower cervical congenital anomalies include persisting transverse process apophyses, persisting epiphyses, vertebral platyspondylia, vertebral hypoplasia, and vertebral arch dysplasia [9][10][11] . Anomalies of the cervical spinous process are extremely rare and asymptomatic but can present with localized pain 12,13 . In the current article, we report a rare case of a giant anomalous, free-floating C5 spinous process causing dynamic compression resulting in myelopathy.…”

mentioning

confidence: 99%

Giant Anomalous Cervical Spinous Process Causing Dynamic Cord Compression: An Unusual Cause for Myelopathy

Ramachandran,

Patel,

Arumugam

et al. 2023

JBJS Case Connector

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Case: A 47-year-old male patient presented with progressively worsening gait instability caused by a giant anomalous, free-floating C5 spinous process resulting in dynamic cord compression and myelopathy. The patient was successfully managed with a C5 laminectomy and total excision of the anomalous spinous process with a good functional outcome at the final follow-up. Conclusion: Anomalies of the posterior arch of the subaxial cervical spine are relatively uncommon and asymptomatic. This case is being reported for its rarity and to highlight the role of dynamic imaging in patients presenting with congenital anomalies of the cervical spine presenting with compressive myelopathy.

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Anomalous Cervical Spinous Process Leading to Myelopathy

Abstract: Though hitherto unreported, this rare anomaly of anomalous spinous process needs to be borne in mind while evaluating a relatively young patient with myelopathy. Surgical excision of the free-floating anomalous spinous process yields satisfactory outcome.

Cited by 5 publications

References 9 publications

Axis spinous process malformations are commonly identified in a sample of English Bull Terriers without associated clinical signs

Axis spinous process malformations are commonly identified in a sample of English Bull Terriers without associated clinical signs

Cervical Myelopathy Caused by Invagination of Floating Anomalous C2 and C3 Laminae in the Spinal Canal

Giant Anomalous Cervical Spinous Process Causing Dynamic Cord Compression: An Unusual Cause for Myelopathy

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