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Winking owl sign (spine)

Last revised by Dr Mostafa El-Feky on 28 Dec 2021

The (absent) pedicle sign, also called the winking owl sign, occurs on plain radiograph of the spine when a pedicle is absent 5.

The term, winking owl sign, where the missing pedicle corresponds to the closed eye, the contralateral pedicle to the other round open eye, and the spinous process to the beak of the owl on AP views of the thoracic or lumbar spine 1,2.

Pathology

Etiology

There is a wide etiology 3,4:

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Cases and figures

  • Figure 1: winking owl
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  • Case 1: absent right L4 pedicle
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  • Case 2: absent left T11 pedicle
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  • Case 3: absent left L2 pedicle
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  • Case 4
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  • Case 5: congenital
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  • Case 6
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  • Case 7: absent right L1
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  • Case 8: L1
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  • Case 9: right side of T12
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