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Ahead of Print
Case report
Submitted: 2023-12-07
Accepted: 2024-01-05
Published online: 2024-02-14
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Two simultaneous anatomical variations of the cervical spine – a case report discussing the concept of tandem anomalies

Joanna Jaworek-Troć1, Izabela Zamojska1, Michał Zarzecki2, Bartosz Kołodziejczyk1, Jerzy Andrzej Walocha1, Jarosław Zawiliński1, Marcin Lipski1, Przemysław Pękala1
·
Pubmed: 38390746
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Department of Neonatology and Neonatal Intensive Care, the Children’s Memorial Health Institute, Warsaw, Poland

open access

Ahead of Print
CASE REPORTS
Submitted: 2023-12-07
Accepted: 2024-01-05
Published online: 2024-02-14

Abstract

forming a bony opening through which the vertebral artery (VA) enters the vertebral canal. Block vertebra is a synostosis of at least two vertebral bodies that did not separate during the embryological development. It is worth distinguishing it from the Klippel-Feil syndrome, as the latter oftentimes involves other abnormalities (namely skeletal) and is typically diagnosed in childhood. Both variants could potentially lead to an impairment of the blood flow through the VA. Case report: The following case report presents a finding of two 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, 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. Common presence of at least two 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.

Abstract

forming a bony opening through which the vertebral artery (VA) enters the vertebral canal. Block vertebra is a synostosis of at least two vertebral bodies that did not separate during the embryological development. It is worth distinguishing it from the Klippel-Feil syndrome, as the latter oftentimes involves other abnormalities (namely skeletal) and is typically diagnosed in childhood. Both variants could potentially lead to an impairment of the blood flow through the VA. Case report: The following case report presents a finding of two 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, 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. Common presence of at least two 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.

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Keywords

arcuate foramen; vertebral synostosis; vertebral artery; anatomy; radiology

About this article
Title

Two simultaneous anatomical variations of the cervical spine – a case report discussing the concept of tandem anomalies

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2024-02-14

Page views

134

Article views/downloads

98

DOI

10.5603/fm.98453

Pubmed

38390746

Keywords

arcuate foramen
vertebral synostosis
vertebral artery
anatomy
radiology

Authors

Joanna Jaworek-Troć
Izabela Zamojska
Michał Zarzecki
Bartosz Kołodziejczyk
Jerzy Andrzej Walocha
Jarosław Zawiliński
Marcin Lipski
Przemysław Pękala

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