Absent cervical spine pedicle: report of a case in a mediaeval skeleton

This paper presents a first dry-bone study of the anatomy of an absent cervical spine pedicle and briefly reviews the literature involving this anomaly. The case study is of the absence of the right cervical spine pedicle at C6 in a mediaeval skeleton from England. Key features of the anomaly, including, in addition to the absent pedicle, dysplasia of the ipsilateral transverse process, dorsal displacement of the articular pillar, and reversal of the ipsilateral facet articulation with the supra-adjacent vertebra, are illustrated. Compromise of cervical spine stability is demonstrated. Literature review revealed 69 cases of absent cervical spine pedicle; all were unilateral, and there was no side or gender preference. The current case is a first description of an absent cervical spine pedicle in an archaeological skeleton. It indicates the presence of the anomaly in a European population more than 600 years before the first clinical description. Absent cervical spine pedicle appears to be a rare variant today; the paucity of archaeological cases shows that this was also the case in the past.