J Korean Soc Radiol.  2015 Sep;73(3):181-185. 10.3348/jksr.2015.73.3.181.

Two Consecutive Levels of Unilateral Cervical Spondylolysis on Opposite Sides

• Ryu KH
• Kim SJ
• Kim OH
• Kim SH
• Lee KH
• Baek HJ
• Lee Y
• Cha YK

• KMID: 2043609
• DOI: http://doi.org/10.3348/jksr.2015.73.3.181

Abstract

Cervical spondylolysis, with or without spondylolisthesis, is a rare condition defined as a corticated cleft between the superior and inferior articular facets of the articular pillar. The defect occurs predominantly at C6, and is usually bilateral in up to two-thirds of cases. Multilevel involvement is uncommon, however, to date, no case of two consecutive levels of unilateral cervical spondylolysis on opposite sides has been reported. Here, we report a rare case of a patient affected by two consecutive levels of unilateral cervical spondylolysis at C5 and C6 on opposite sides in a 19-year-old male complaining of neck pain.

MeSH Terms

Humans
Male
Neck Pain
Spondylolisthesis
Spondylolysis*
Young Adult

Figure

• 

  Fig. 1 Plain radiographs of the cervical spine. A. Anteroposterior radiograph showing spina bifida of C5 (arrow). B. Lateral radiograph in flexion showing well-defined spondylolytic defects that divide the articular pillar of C5 (arrow 1) and C6 (arrow 2) vertebra into two fragments. Spina bifida (arrow 3) of C5 is also revealed.

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  Fig. 2 CT scans of the cervical spine. A. Axial CT image showing a smoothly-marginated defect in the right articular pillar of C5 (arrow). B. Axial CT image showing a well-corticated defect in the left articular pillar of C6 with irregular-shaped ossification (arrow) between the ventral (V) and dorsal fragment (D). C. Axial CT image revealing spina bifida (arrow 1) and right dysplastic lamina (arrow 2) of C5. D. Axial CT image showing left dysplastic lamina of C6 (arrow 1), articulation (arrow 2) between the dorsal fragment of the C6 articular pillar and C7, and ossification (arrow 3) within the defect in the left articular pillar of C6. E. Reformatted sagittal CT image on the right side revealing a defect (arrow) in the right articular pillar of C5. The ventral fragment (V) of the articular pillar of C5 articulates with the facet of C4, and the dorsal fragment (D) articulates with the facet of C6. F. Reformatted sagittal CT image on the left side showing ossifications (arrows) in the defect in the C6 left articular pillar. The ventral (V) and dorsal (D) fragments articulate with the facets of C5 and C7, respectively. G, H. Three-dimensional volume rendering-CT images showing dysplastic laminae (L), corticated clefts (arrows) dividing the articular pillars into ventral (V) and dorsal (D) fragments.

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  Fig. 3 MR image of the cervical spine. Sagittal T2-weighted MR image showing no evidence of spinal cord compression or signal abnormality, discoligamentous structure injury or bone marrow edema.

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