Congenital Spondylolisthesis of the Sixth Cervical Vertebra

Kong, Doo Sik; Park, Kwan; Cho, Byung Moon; Kim, Jong Hyun

Abstract

Bilateral cervical spondylolysis with spondylolisthesis is a rare congenital anomaly involving a complex malformation of the posterior elements of the cervical vertebra accompanied by a spondylolisthesis. It is a part of the spectrum of cervical spondylolysis and usually occurs at C-6. It is important to recognize this anomaly, particularly in trauma or other pathological conditions, to avoid mistaking it with the other more serious entities such as fractures, locked facets, and bony erosions by tumor. We report a case of congenital spondylolisthesis of the sixth cervical vertebra and outline the radiographic findings for differential diagnosis. A 41-year-old male was presented with a di-fficulty in moving his neck for one and a half months. He also complained of tingling sensation in both upper extremities. Clinical and radiological evaluations showed that he had congenital cervical spondylolisthesis. On the plain cervical spine films, there was an anterior displacement of the sixth cervical vertebra on the seventh vertebra. CT scan demonstrated bilateral defects of pars interarticularis of the sixth vertebra. There was also a lengthening antero-posterior(AP) diameter in the central canal at C6 level. The spinous process of C6 showed a spina bifida. We perfo-rmed an anterior interbody fusion using an autologous iliac bone, plate and screw fixation. It is important for the physicians to recognize the difference between the congenital cervical spondylolisthesis and fracture or other pathological conditions to institute an appropriate therapy. This anomaly may have clinical implications and may even require surgical interventions. We report a rare case of a congenital spondylolisthesis of the 6th cervical vertebra successfully treated with surgical intervention with a review of pertinent literature.