Congenital Absence of a Pedicle of L4 in the Spinal Stenosis: A Case Report / 대한척추외과학회지

ABSTRACT

Congenital absence of a lumbar pedicle is an uncommon anomaly, and most cases are asymptomatic and discovered incidentally. A 72-year-old man presented with lower back pain that radiated to his bilateral lower extremities. Physical examination revealed no neurological deficits. Plain radiographs of the lumbar spine revealed absence of the left L4 pedicle, along with hypertrophy and sclerosis of the contralateral pedicle. Magnetic resonance imaging showed stenosis of the L3-4 neural canal. Computed tomography revealed absence of the left L4 pedicle associated with hypertrophy and sclerosis of the right L4 pedicle and facet joint. The symptoms of the patient were resolved after posterior decompression without fusion. Here, we report one case of congenital absence of an L4 pedicle detected in a spinal stenosis patient who need to undergo a decompressive surgery for the spinal stenosis caused by contralateral facet hypertrophy.