Presentation
Thoracic spine pain (T2-T4) which wakes patient up at night. Rule out bone lesion.
Patient Data
Defect of fusion of the spinal processes of C7, T1 and T2 and T3 and T10, compatible with unfused and incomplete fused spinal processes.
Calcium deposit involving the anterior annulus fibrosis of the mid and lower thoracic spine and the ligamentum flavum at T11-T12.
No other significant abnormality, including bone lesion identified.
Case Discussion
Congenitally unfused and incompletely fused spinous processes are normal anatomical variants in the spectrum of spina bifida occulta. Those types of anomaly are relatively common at the cervical and lumbar spine but rare at the thoracic level 1. Here we present 2 completed and 2 incomplete fused thoracic spinal processes in addition to an unfused C7 spinal process.
Those anatomical variants are usually found incidentally and are not to be mistaken for fractures. In our case, they are unlikely to have been the cause of our patient's presentation.
She went on to have a contrast-enhanced CT chest, which revealed no findings to explain her pain.
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