Short Spinous Process of Cervical Vertebrae in a Sudanese Subject: A Case Report
Abstract
Introduction: The spinous process is part of the vertebrae and provides muscle
attachment for some muscles and ligaments. They are important landmarks and play a
role in screw placement during surgical intervention. This report describes a case of a
Sudanese with a short cervical spinous process and draws attention to the possibility
of anatomical variations in general and the shortage of cervical spinous processes
specifically.
Case Report: A 70-year-old Sudanese male presented to the emergency department
following a road traffic accident. After standard management and patient stabilization,
the X-ray showed that the spinous processes of C 3, 4, and 5 cervical vertebrae were
short, and those of C 6 and 7 have abnormal anatomy. The inter-spinous distances
were well-maintained. The joints and articulations processes of cervical vertebrae
were normal without cortication. The patient was stable and admitted for 24 hr for
observation and then discharged on analgesics.
Conclusion: This is the first case report of the short spinous process among Sudanese.
Some of the cervical spinous processes were short, and others had abnormal anatomy.
No obvious manifestations were linked to the case. Discussion of anatomical variations
should be carried out and implemented with care and in line with the normal and
latest developments in biological, anthropology, forensic, and related sciences. Such
anatomical abnormality should be considered during radiographing, preparation,
and surgical intervention planning. The normal adaption resulting from congenital
abnormality or variation can be used as a method for reconstruction surgeries and
provides alternatives to clinical management.
References
and the biomechanics of injury due to compressive loading. Journal of Athletic
Training, vol. 40, no. 3, p. 155.
[2] Drake, R., Vogl, A. W., and Mitchell, A. W. M. (2019). Gray’s anatomy: For students.
USA: Elsevier Health Sciences.
[3] Nambiar, S., Mogra, S., Nair, B. U., et al. (2014). Morphometric analysis of cervical
vertebrae morphology and correlation of cervical vertebrae morphometry, cervical
spine inclination and cranial base angle to craniofacial morphology and stature in
an adult skeletal class I and class II population. Contemporary Clinical Dentistry, vol.
5, no. 4, pp. 456–460.
[4] Rao, E. V., Rao, S., and Vinila, S. (2016). Morphometric analysis of typical cervical
vertebrae and their clinical implications: a cross sectional study. International Journal
of Anatomy and Research, vol. 4, no. 4.1., pp. 2988–2992.
[5] Chen, C., Ruan, D., Wu, C., et al. (2013). CT morphometric analysis to determine
the anatomical basis for the use of transpedicular screws during reconstruction and
fixations of anterior cervical vertebrae. PloS One., vol. 8, no. 12, p. e81159.
[6] Kaplan, K. M., Spivak, J. M., and Bendo, J. A. (2005). Embryology of the spine and
associated congenital abnormalities. The Spine Journal, vol. 5, no. 5, pp. 564–576.
[7] Kim, H. J. (2013). Cervical spine anomalies in children and adolescents. Current
Opinion in Pediatrics, vol. 25, no. 1, pp. 72–77.
[8] Richardson, P., Drake, R. L., Horn, A., et al. (2018). Gray’s basic anatomy. China:
Elsevier Health Sciences.
[9] Rameez, F., Mufti, M., and Hilal, K. (2017). Hyperplasia of Lamina and Spinous Process
of C5 Vertebrae and Associated Hemivertebra at C4 Level. Journal of Orthopaedic
Case Reports, vol. 7, no. 1, pp. 79–81.
[10] Ludwisiak, K., Podgórski, M., Biernacka, K., et al. (2019). Variation in the morphology
of spinous processes in the cervical spine–An objective and parametric assessment
based on CT study. PloS One, vol. 14, no. 6, p. e0218885.
[11] Farooqi, R., Mehmood, M., and Kotwal, H. (2017). Hyperplasia of lamina and spinous
process of C5 vertebrae and associated hemivertebra at C4 level. Journal of
Orthopaedic Case Reports, vol. 7, no. 1, pp. 79–81.
[12] Solomon, B. D., Raam, M. S., Pineda-Alvarez, D. E. (2011). Analysis of genitourinary
anomalies in patients with VACTERL (Vertebral anomalies, Anal atresia, Cardiac
malformations, Tracheo-Esophageal fistula, Renal anomalies, Limb abnormalities)
association. Congenital Anomalies, vol. 51, no. 2, pp. 87–91.
[13] Panjabi, M. M., Duranceau, J., Goel, V., et al. (1991). Cervical human vertebrae.
Quantitative three-dimensional anatomy of the middle and lower regions. Spine,
vol. 16, no. 8, pp. 861–869.
[14] Tan, S., Teo, E., and Chua, H. (2004). Quantitative three-dimensional anatomy of
cervical, thoracic and lumbar vertebrae of Chinese Singaporeans. European Spine
Journal, vol. 13, no. 2, pp. 137–146.
[15] Doherty, B. J. and Heggeness, M. H. (1995). Quantitative anatomy of the second
cervical vertebra. Spine, vol. 20, no. 5, pp. 513–517.
[16] Greiner, T. M. (2017). Shape analysis of the cervical spinous process. Clinical
Anatomy, vol. 30, no. 7, pp. 894–900.
[17] Oh, S.-H., Perin, N. I., and Cooper, P. R. (1996). Quantitative three-dimensional
anatomy of the subaxial cervical spine. Implication for anterior spinal surgery.
Neurosurgery, vol. 38, no. 6, pp. 1139–1144.
[18] Moore, K. L., Persaud, T. V. N., and Torchia, M. G. (2018). The developing human-ebook: clinically oriented embryology. Amsterdam, The Netherlands: Elsevier Health
Sciences.
[19] Chaturvedi, A., Klionsky, N. B., Nadarajah, U., et al. (2018). Malformed vertebrae: A
clinical and imaging review. Insights into Imaging, vol. 9, no. 3, pp. 343–355
[20] Ravikanth, R. and Pottangadi, R. (2018). Nonunited secondary ossification centers
of the spinous processes of vertebrae at multiple levels presenting as aberrant
articulations in an adult. Journal of Craniovertebral Junction & Spine, vol. 9, no. 3,
pp. 216–217.
[21] Bazaldúa, C., González, L., Gómez, S., et al. (2011). Morphometric study of cervical
vertebrae C3-C7 in a population from northeastern Mexico. International Journal of
Morphology, vol. 29, no. 2, pp. 325–330.
[22] Cho, W., Maeda, T., Park, Y., et al. (2012). The incidence of bifid C7 spinous processes.
Global Spine Journal, vol. 2, no. 2, pp. 99–103.
[23] Tubbs, R. S., Shoja, M. M., and Loukas, M. (2016). Bergman’s comprehensive
encyclopedia of human anatomic variation. Hoboken, NJ: John Wiley & Sons.
