Presentation
Neck pain
Patient Data

There is a mild to moderate right convexity of the cervicothoracic spine, with dysplastic posterior elements at C7.
C7 demonstrates spina bifida occulta, hypertrophied right transverse process and pedicle, and absent left transverse process and pedicle.

The hyperplastic right transverse process is outlined in yellow.
The enlarged right pedicle is outlined in green, with a green arrow pointing to the left side where there is no pedicle or transverse process.
The spina bifida occulta is outlined in blue.
Case Discussion
It is important to distinguish congenitally absent pedicle from a destroyed pedicle. In this case it is quite easy, with the hyperplastic contralateral posterior elements and neural arch defect.