Hyperplasia of Lamina and Spinous Process of C5 Vertebrae and Associated Hemivertebra at C4 Level

Congenital variants of the cervical spine may mimic traumatic lesions and may cause recurrent episodes of pain. The spectrum of cervical variants includes persistent apophyses of the transverse processes, persistent epiphyses, vertebral platyspondylia, vertebral hypoplasia, and dysplasia of the vertebral arch. Furthermore, abnormalities of the spinous process have been described including doubled spinous processes and hypertrophies. Unilateral hyperplasia of a spinous process is a rare finding that has only been described rarely as case reports.

We report a 9-year-old male child who was referred to us with swelling in the posterior aspect of the neck. Anteroposterior and lateral radiographs of the cervical spine show an elongated left spinous process in the neck at the level of C5 vertebrae. There was an associated hemivertebra at the C4 level. Computed tomography examination better depicted this congenital variant and clearly showed the associated schisis of the posterior arch as well as unfused spinous process at the same level on the left side. This is a very rare congenital anomaly and probably among the few such cases reported in literature.

Rare congenital spinal abnormalities including unilateral hyperplasia of a spinous process have to be kept in mind as a differential diagnosis in patients with posterior midline neck swelling and recurrent episodes of cervical neck pain.