title: Misdiagnosing Absent Pedicle of Cervical Spine in the Acute Trauma Setting.
abstract: Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT)-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms.
authors.affiliation: McGill Scoliosis and Spine Centre, McGill University Health Centre , Montreal, Canada ; Department of Orthopedic Surgery, King Abdulaziz University , Jeddah, Saudi Arabia.
authors.forename: Fahad H
authors.initials: FH
authors.lastname: Abduljabbar
authors.affiliation: McGill Scoliosis and Spine Centre, McGill University Health Centre , Montreal, Canada.
authors.forename: Felipe
authors.initials: F
authors.lastname: Rossel
authors.affiliation: McGill Scoliosis and Spine Centre, McGill University Health Centre , Montreal, Canada ; Department of Orthopedic Surgery, King Abdulaziz University , Jeddah, Saudi Arabia.
authors.forename: Anas
authors.initials: A
authors.lastname: Nooh
authors.affiliation: McGill Scoliosis and Spine Centre, McGill University Health Centre , Montreal, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Jarzem
keywords: Absent pedicle; cervical spine; congenital abnormalities