Cervical myelopathy secondary to omovertebral bone in the pediatric patient with Sprengel deformity

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Figure 1
CT cervical spine A) sagittal view with extension of the omovertebral bone dorsally at level of C4 arrow indicate lamina of C4), arrow head indicate the downward extension of omovertebral bone), B) axial view showed the presence of omovertebral bone at the level of C4 vertebrae
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Figure 2
MRI cervical spine A) showed impingement of the omovertebral bone over the dorsal aspect of the spinal cord, B) Arrow head showed loss of CSF signal with spinal cord impingement at C4 level.
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Figure 3
Intraoperative view A) Intraoperative exposure of the omovertebral bone before completely resected, B) showed the bone after complete resection which measured 6cm in its length.
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Figure 4
Timeline of patient’s clinical condition and management.

Table 1

Cavendish classification.

Grades	Clinical features
1	Very mild deformity is observed. When covered with clothes the deformity is almost invisible.
2	The deformity is still mild, but appears as bump. The superomedial portion of the high scapula is convex, forming a bump.
3	Moderate deformity with 2-5 cm visible elevation of the affected shoulder compared to normal one
4	Severe deformity with > 5 cm elevation of the affected shoulder accompained by neck webbing.

Reproduced with permission from: Dilli A, Ayaz UY, Damar C, Ersan O, Hekimoglu B. Sprengel deformity: magnetic resonance imaging findings in two pediatric cases. J Clin Imaging Sci 2011; 1: 13.