Document Detail

Case report: absent C6 cervical pedicle in a collegiate football player.
MedLine Citation:
PMID:  19680734     Owner:  NLM     Status:  MEDLINE    
Congenital absence of a cervical pedicle is a rare clinical finding with only 70 reported cases in the literature from 1946 until present. The congenitally absent pedicle has clinical importance owing to the frequency of misdiagnosis and inappropriate invasive treatments. We present the case of a 21-year-old college football player who experienced neck and shoulder pain after violent twisting of his neck by the face mask. The player walked off the field under his own power. He was sent to the locker room, where he underwent right shoulder and cervical spine radiographs. Initial review of the radiographs raised concern for a jumped right C6 facet. The patient then underwent CT and MRI of the cervical spine, confirming the diagnosis of an absent cervical pedicle. He was treated nonoperatively for a short time and completed the season. He had no symptoms at last followup at 8 months. The most frequent location of the absent cervical pedicle is at the C6 level, and the next most common is at the C5 level. Neural compression or instability is uncommon and nonsurgical treatment is the mainstay of treatment. Misdiagnosis can lead to inappropriate treatment such as halo or tong application with traction, which occurred in seven of 57 cases in one series, and exploratory surgery, which occurred in four of 57 cases.
John R Fowler; Ray A Moyer
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-08-13
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-05-20     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1693-6     Citation Subset:  AIM; IM    
Department of Orthopaedics, Temple University School of Medicine, 6th Floor Outpatient Building, 3401 N Broad Street, Philadelphia, PA 19140, USA.
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MeSH Terms
Cervical Vertebrae / abnormalities*,  radiography
Football / injuries*
Incidental Findings*
Magnetic Resonance Imaging
Neck Pain / diagnosis*,  etiology,  therapy
Shoulder Pain / diagnosis*,  etiology,  therapy
Tomography, X-Ray Computed
Young Adult

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