DESCRIPTIVE STUDY OF THE CERVICAL SPINE NONSEGMENTATION USING CONE BEAM COMPUTED TOMOGRAPHY

Abstract

<h3>BACKGROUND</h3> Vertebral nonsegmentation occurs because of segmentation failure of the vertebrae. The etiology of this failure can be congenital or acquired. The congenital nonsegmentation vertebrae may be partial or complete fusion at the body or the articular facets or in the transverse processes. The cervical vertebrae are the most commonly involved in the spine. These vertebrae are routinely visualized in cone beam computed tomography (CBCT), and the diagnosis is more precise in identifying nonsegmentation compared with the higher percentage of the false-positive findings on lateral cephalometric radiographs. <h3>OBJECTIVE(S)</h3> To describe the cervical spine nonsegmentation and any other incidental findings associated with it using CBCT. <h3>STUDY DESIGN</h3> Fifty CBCT radiographic reports were retrieved from the archived cases database of the Oral and Maxillofacial Radiology Department at The University of Iowa, after institutional review board approval. All reports documented nonsegmentation in the cervical spine. Patient age and sex were collected and the scans were assessed for the level of segmentation, the affected side, and any other associated pathosis in the vertebral region. <h3>RESULTS</h3> For the 50 CBCT scans patient age ranged from 11 to 93 years old (average = 52.7). There were 23 male and 27 female patients. The highest number of vertebral nonsegmentation was found between C2 and C3 in 35 patients, followed by 7 cases between C4 and C3. Two cases had fusion between the occipital bone and C1. Two patients had vertebral nonsegmentation in 2 different regions, 1 in C0-C1 and C2-C3 and the other in C2-C3 and C2-C3-C4. Most of the cases had partial nonsegmentation. <h3>DISCUSSION/CONCLUSIONS</h3> Congenital cervical spine nonsegmentation can be easily identified in CBCT scans. These congenital anomalies might be asymptomatic and can cause restricted movement that may lead to neurologic implications. Therefore, the identification and documentation of this abnormality on CBCT scans is highly recommended.