Farooqi Raja Rameez, Mehmood Mufti, Kotwal Hilal A
Department of Orthopaedics, Government Medical College, Srinagar, Jammu & Kashmir, India.
J Orthop Case Rep. 2017 Jan-Feb;7(1):79-81. doi: 10.13107/jocr.2250-0685.698.
Congenital variants of the cervical spine may mimic traumatic lesions and may cause recurrent episodes of pain. The spectrum of cervical variants includes persistent apophyses of the transverse processes, persistent epiphyses, vertebral platyspondylia, vertebral hypoplasia, and dysplasia of the vertebral arch. Furthermore, abnormalities of the spinous process have been described including doubled spinous processes and hypertrophies. Unilateral hyperplasia of a spinous process is a rare finding that has only been described rarely as case reports.
We report a 9-year-old male child who was referred to us with swelling in the posterior aspect of the neck. Anteroposterior and lateral radiographs of the cervical spine show an elongated left spinous process in the neck at the level of C5 vertebrae. There was an associated hemivertebra at the C4 level. Computed tomography examination better depicted this congenital variant and clearly showed the associated schisis of the posterior arch as well as unfused spinous process at the same level on the left side. This is a very rare congenital anomaly and probably among the few such cases reported in literature.
Rare congenital spinal abnormalities including unilateral hyperplasia of a spinous process have to be kept in mind as a differential diagnosis in patients with posterior midline neck swelling and recurrent episodes of cervical neck pain.
颈椎先天性变异可能类似创伤性病变,并可能导致反复疼痛发作。颈椎变异的范围包括横突持续骨骺、持续骨骺、椎体扁平、椎体发育不全以及椎弓发育异常。此外,还描述了棘突异常,包括双棘突和肥大。棘突单侧增生是一种罕见的发现,仅有少数病例报告。
我们报告一名9岁男性儿童,因颈部后方肿胀前来就诊。颈椎正侧位X线片显示,在C5椎体水平处颈部左侧棘突拉长。在C4水平处伴有半椎体。计算机断层扫描检查更好地描绘了这种先天性变异,并清楚地显示了同一水平左侧后弓的相关裂隙以及未融合的棘突。这是一种非常罕见的先天性异常,可能是文献中报道的少数此类病例之一。
对于颈部后正中线肿胀和反复出现颈部疼痛的患者,必须考虑包括棘突单侧增生在内的罕见先天性脊柱异常作为鉴别诊断。