Aberrant Articulation of Cervical Vertebral Transverse Process: An Uncommon Normal Variant and Review of the Literature

Accessory articulation of elongated anterior transverse process: a rare anatomical variant of the cervical spine depicted with CT and post-processing techniques

“…Here, we present the case of a rare anatomical variant of the cervical spine, consisting of a unilateral accessory articulation between the 5th and 6th cervical vertebrae, due to elongated anterior transverse processes. Our search found only three cases in the English literature describing similar findings to the case here reported [1,3,6]. The present case is, to our knowledge, the first report of this anatomical variant imaged with computed tomography (CT) including post-processing images.…”

“…The transverse processes, with which the tubercles of the ribs articulate, are formed by lateral extension of the neural process centers, which also extend ventrally to fuse with the centrum [1,6]. The costal element of the transverse processes is present prominently in the thoracic vertebrae but not in the cervical vertebrae, as it fuses with the ossification center of the transverse process by the 6th year [2].…”

A Previously Unreported Variant of a Thoracic Vertebra

“…In all these case reports, there was no conclusive evidence to attribute the anomalies with the symptomatology of the patients. The findings of the enlarged transverse process were attributed as incidental findings on radiology [3][4][5]. However, in the case report involving the anomaly in the lumbar spine, they did find an association between the patient's symptoms and an enlarged transverse process [6].…”

“…Upon further review of the case reports concerning enlargement of the transverse process of the cervical vertebrae, which is hypothesized to be a form of supernumerary cervical ribs developing at a level above the lowest cervical vertebra, all the patients presented with different neurological complaints ranging from neck pain to numbness and tingling [3][4][5]. In all these case reports, there was no conclusive evidence to attribute the anomalies with the symptomatology of the patients.…”

“…Bergman, et al state in their Illustrated Encyclopedia of Human Anatomic Variation, "the transverse process of the seventh vertebra may be bifid [2]," which is the only anatomic variant regarding such that is referenced. Another variation, documented by a few authors but still very rare, is elongation of the anterior part of the transverse process in the cervical spine [3][4][5]. According to the case reports, the transverse process anomaly presents as a bony projection anterior to the vertebral body found on imaging of the spine.…”