Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Australia.
Department of Medical Imaging, Princess Alexandra Hospital, Australia.
Neuroradiol J. 2020 Jun;33(3):252-258. doi: 10.1177/1971400920923284. Epub 2020 May 13.
This study aimed to describe the imaging spectrum of developmental anomalies of the lateral portion of the cervical neural arch.
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.
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%).
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.
本研究旨在描述颈椎神经弓外侧部分发育异常的影像学表现。
这是一项对颈椎椎弓根和关节突结构异常的连续颈椎 CT 扫描进行的五年回顾性研究。独立评估 CT、射线照片和有条件时的磁共振成像研究。将异常分为以下三类：椎弓根缺失、椎弓裂或关节突孤立发育不良。记录了人口统计学和神经学结果的临床数据。
在 9134 例连续行颈椎 CT 扫描的患者中，发现 18 例（0.2%）存在椎弓根和关节突发育异常。发现包括 7/18（39%）先天性椎弓根缺失、8/18（44%）椎弓裂和 3/18（17%）关节突孤立发育不良。无急性神经功能缺损或脊髓损伤报告。相关的慢性症状包括颈部疼痛 10/18（56%）、神经根病 7/18（39%）和脊髓病 1/18（6%）。
椎弓根和关节突的发育异常可能类似于创伤性脊柱病变。认识到广泛的影像学表现对于防止误诊和不必要的干预至关重要。
