Asymptomatic Cervical Isthmic Spondylolisthesis and Associated Occult Spinal Bifida: A Case Report
A 23-year-old female suffered from a hyperextension injury to cervical spine after a traffic accident. Following this injury, she experienced mild to moderate degree of nuchal and back pain. She had no neurological symptoms or signs. There was no history of significant illness or trauma in the past.\nPlain radiograph of the cervical spine showed bilateral pars interarticularis defect at the C6 level with cleft-bow-tie configuration, hypoplastic pedicle, grade I spondylolisthesis of C6 on C7 and spinal bifida at C6 (). Computed tomography of the C6 vertebrae showed bilateral corticated defects of the C6 articular mass, bilateral hypoplastic pedicles, lamina and spinal bifida of C6 and apparent neural foraminal enlargement at C6-7 (). The magnetic resonance image of spine showed grade I spondylolisthesis C6-7, degenerative change of C6-7 disc and acute compressed fracture at 4th thoracic vertebrae. She was subjected to controlled flexion-extension views of the cervical spine, which confirmed stability of the segment with less than 10 degrees of anterior angulations (). The cervical spine was stable on lateral flexion and extension radiography.\nShe was treated with the semihard-orthosis brace immobilization for 8 weeks followed by repeated lateral cervical spine radiography. After 10 months to injury, she was symptom free with full range of motion of cervical spine.