Folia morphologica · 2024
Two simultaneous anatomical variations of the cervical spine - a case report discussing the concept of tandem anomalies.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Jaworek-Troć Joanna, Zamojska Izabela, Zarzecki Michał P, Kołodziejczyk Bartosz, Walocha Jerzy A, Zawiliński Jarosław, Lipski Marcin, Pękala Przemysław
Аннотация
BACKGROUND: Arcuate foramen is an ossification of the posterior atlanto-occipital membrane, forming a bony opening through which the vertebral artery (VA) enters the vertebral canal. Block vertebra is a synostosis of at least 2 vertebral bodies that did not separate during the embryological development. It is worth distinguishing it from Klippel-Feil syndrome, as the latter oftentimes involves other abnormalities (namely skeletal) and is typically diagnosed in childhood. Both variants potentially lead to impairment of blood flow through the VA.
CASE REPORT: The following case report presents a finding of 2 anomalies of the cervical spine, found in a 38 y.o. female patient suffering from dizziness. A synostosis of the C4 and C5 vertebral bodies, arches, and zygapophysial (facet) joint was noted by the examining radiologist, with marked narrowing of the intervertebral foramen. Furthermore, a second anatomical variation in the form of the complete bilateral arcuate foramen was identified superior to the groove for the VA on the upper surface of the posterior arch of the atlas.
CONCLUSIONS: To the best knowledge of the authors, this case report is the first to present a co-existing block vertebra and bilateral complete arcuate foramen. The common presence of at least 2 anatomical variations that could have a synergistic clinical effect could possibly be termed 'tandem anomaly'. Notwithstanding, identification of a single anomaly explaining a patient's symptoms does not absolve the medical professionals from searching for any other potential variations that could also be present and could further influence the clinical picture.
CASE REPORT: The following case report presents a finding of 2 anomalies of the cervical spine, found in a 38 y.o. female patient suffering from dizziness. A synostosis of the C4 and C5 vertebral bodies, arches, and zygapophysial (facet) joint was noted by the examining radiologist, with marked narrowing of the intervertebral foramen. Furthermore, a second anatomical variation in the form of the complete bilateral arcuate foramen was identified superior to the groove for the VA on the upper surface of the posterior arch of the atlas.
CONCLUSIONS: To the best knowledge of the authors, this case report is the first to present a co-existing block vertebra and bilateral complete arcuate foramen. The common presence of at least 2 anatomical variations that could have a synergistic clinical effect could possibly be termed 'tandem anomaly'. Notwithstanding, identification of a single anomaly explaining a patient's symptoms does not absolve the medical professionals from searching for any other potential variations that could also be present and could further influence the clinical picture.