Developmental anomalies of the lateral portion of the cervical neural arch: Multimodal imaging and clinical implications

Abstract

Objective This study aimed to describe the imaging spectrum of developmental anomalies of the lateral portion of the cervical neural arch. Method This was a five-year retrospective review of consecutive computed tomography (CT) scans of the cervical spine for structural anomalies of the cervical vertebral pedicle and facets. CT, radiographs and, when available, magnetic resonance imaging studies were independently reviewed. Anomalies were grouped into the following three categories: the absence of a pedicle, clefts in the vertebral arch or isolated dysmorphism of the facet. Clinical data on demographics and neurological outcomes were documented. Results Among 9134 consecutive patients undergoing a CT scan of the cervical spine, 18 (0.2%) patients were found to have developmental anomalies of the pedicle and facets. Findings included 7/18 (39%) with congenital absence of a pedicle, 8/18 (44%) with clefts in the vertebral arch and 3/18 (17%) with isolated dysmorphism of the articular facets. No acute neurological deficits or spinal cord injuries were reported. Associated chronic symptoms included neck pain 10/18 (56%), radiculopathy 7/18 (39%) and myelopathy 1/18 (6%). Conclusion Developmental anomalies of the pedicle and facet may mimic traumatic spinal pathologies. Recognising a diverse spectrum of imaging findings is vital to prevent misdiagnosis and unnecessary intervention.

Beyond the Bony Fragment: A Review of Limbus Vertebra

“…The exact surgical approach depends on various factors, including the location and size of the fragment, the presence of instability, and associated pathologies. Any and all anatomical variants and morphological features of the spine, musculature, vessels, and adjacent structures should be adequately reported when surgery is considered, in order to prevent intraoperative accidents [23][24][25]. Preoperative planning using dedicated AI-enhanced software and intraoperative 3D visualization of patient imaging can increase the success rate of the surgical approach [26][27][28][29].…”