A Spine Out of Line: A Novel Vertebral Body Anomaly & Literature Review
Poster #: 027
Session/Time: B
Author:
Nina Li, MS
Mentor:
Trenton Taros, MD
Research Type: Review Article
Abstract
INTRODUCTION:
Vertebral segmentation defects are congenital abnormalities caused by errors in fetal development, leading to incomplete bone formation or failure of separation. Classic examples include hemivertebrae, butterfly vertebrae, and block vertebrae, often associated with congenital scoliosis, Klippel-Feil syndrome, and spondylocostal dysostosis. These anomalies may also occur in broader syndromes such as VACTERL and Down syndrome. While segmentation defects are well-documented, an accessory transverse process of the lumbar spine represents an extremely rare anatomic variant that, to our knowledge, has never been previously described.
MAIN BODY:
A 76-year-old male underwent a radiographic KUB for evaluation of gastrojejunal tube placement. Imaging revealed a distinct osseous projection from the right L2 vertebral body, consistent with an accessory transverse process. Its morphology was clearly distinguishable from hypertrophy, osteophyte formation, or transitional lumbosacral anatomy. The patient also demonstrated partial sacralization of L5 on the right, but no additional segmentation defects, congenital syndromes, or scoliosis. The finding was incidental, and the patient remained asymptomatic. Accessory vertebral processes are exceedingly rare and, to our knowledge, have not been reported in the lumbar spine. This anomaly may reflect duplication during chondrification of the transverse process. While prior cases describe accessory articulations between cervical transverse processes (C5-C6, C6-C7), our report expands the spectrum of vertebral variants to the lumbar region. This entity differs from previously described vertebral anomalies such as hemivertebra (lack of formation of half a vertebral body), block vertebra (two or more bodies are fused), and butterfly vertebra (body appears to be divided into two distinct halves). Awareness of such anomalies is important to prevent misdiagnosis, as they may mimic fracture fragments, osteophytes, or transitional anatomy.
CONCLUSION:
We present the first reported case of an accessory transverse process of the lumbar spine, a novel vertebral anomaly. Awareness of such variants is essential to avoid diagnostic confusion and to broaden the understanding of associated syndromes.
Vertebral segmentation defects are congenital abnormalities caused by errors in fetal development, leading to incomplete bone formation or failure of separation. Classic examples include hemivertebrae, butterfly vertebrae, and block vertebrae, often associated with congenital scoliosis, Klippel-Feil syndrome, and spondylocostal dysostosis. These anomalies may also occur in broader syndromes such as VACTERL and Down syndrome. While segmentation defects are well-documented, an accessory transverse process of the lumbar spine represents an extremely rare anatomic variant that, to our knowledge, has never been previously described.
MAIN BODY:
A 76-year-old male underwent a radiographic KUB for evaluation of gastrojejunal tube placement. Imaging revealed a distinct osseous projection from the right L2 vertebral body, consistent with an accessory transverse process. Its morphology was clearly distinguishable from hypertrophy, osteophyte formation, or transitional lumbosacral anatomy. The patient also demonstrated partial sacralization of L5 on the right, but no additional segmentation defects, congenital syndromes, or scoliosis. The finding was incidental, and the patient remained asymptomatic. Accessory vertebral processes are exceedingly rare and, to our knowledge, have not been reported in the lumbar spine. This anomaly may reflect duplication during chondrification of the transverse process. While prior cases describe accessory articulations between cervical transverse processes (C5-C6, C6-C7), our report expands the spectrum of vertebral variants to the lumbar region. This entity differs from previously described vertebral anomalies such as hemivertebra (lack of formation of half a vertebral body), block vertebra (two or more bodies are fused), and butterfly vertebra (body appears to be divided into two distinct halves). Awareness of such anomalies is important to prevent misdiagnosis, as they may mimic fracture fragments, osteophytes, or transitional anatomy.
CONCLUSION:
We present the first reported case of an accessory transverse process of the lumbar spine, a novel vertebral anomaly. Awareness of such variants is essential to avoid diagnostic confusion and to broaden the understanding of associated syndromes.