Bilateral cervical spondylolysis of C7

Background context

Cervical spondylolysis, which is defined as a cleft between the superior and inferior articular facets of the articular pillar, is a rare condition. The sixth cervical vertebra (C6) is the level most commonly affected. Cases involving C2, C3, C4, or C5 have also been reported. However, to date, no case of C7 spondylolysis has been reported.

Purpose

To present a rare case of bilateral spondylolysis of the seventh cervical vertebra (C7) in a 58-year-old man.

Study design

A case report.

Methods

A 58-year-old man visited our hospital with chronic posterior neck pain radiating to the left upper extremity. Magnetic resonance imaging (MRI) study revealed left foraminal disc herniations at C5–C6 and C6–C7. Cervical spondylolysis involving C7 was discovered incidentally during computed tomography (CT)–guided transforaminal steroid injection. Plain radiographs, CT images, and MRIs were reviewed thoroughly once again.

Results

The patient’s symptoms were relieved after he received CT-guided transforaminal steroid injections. Plain radiographs revealed a radiolucent defect in the articular pillar and cleft at the spinous process of C7. Computed tomography confirmed bilateral spondylolysis and spina bifida occulta of the C7 vertebra. Magnetic resonance imaging revealed absence of edema, which was suggestive of a chronic lesion.

Conclusion

Involvement of C7 is not exceptional in a case of cervical spondylolysis.