Adult Cervical Spondylolysis : a case report

초록

OBJECTIVE: We report a case of spondylolysis with an exceptional involvement of the cervical spine, and its management. BACKGROUND Spondylolysis is turned out to be a defect in the pars interarticularis of a cervical vertebra, and is a common clinical entity in the lumbar spine (5% of the population), however, it rarely occurs in the cervical spine, and congenital one occurs predominantly at the C6 level. The differential diagnosis include congenital absence of a cervical pedicle and trauma. Congenital articular dysplasia is always found, but is not a pathognomonic sign of congenital condition rather than secondary to stress fractures. METHOD A 20-year-old woman was referred with the diagnosis of unstable bipedicular fracture of C6. 2 years aog, she presented neck pain and both shoulder tingling sensation after minor trauma. There was no spinal cord syndrome. The standard x-rays and CT suggested a congenital or acquired anomaly with lysis of the pars interarticularis, spondylolisthesis, and spina bifida occulta at C6 RESULT Anterior interbody fusion C6-7 with Atlantis plate with iliac bone graft performed and the patient was symptom free after surgery. CONCLUSION Cervical spondylolysis is an exceptional anomaly. Diagnosis can be suspected on standard x-ray and is confirmed with CT. Congenital articular dysplasia is always found, but no argument has been put forward which would confirm that spondylolysis is itself a congenital rather than acquired stres lesion.