This young male patient was in a recent motor vehicle accident and presents with cervical spine pain.
Observe the hypoplasia of the C5 and C6 vertebral bodies which represents a mild form of a congenital block vertebrae. Note the anterior bony densities in front of the disc space between C5 and C6. This bony density could be confused with calcification of the anterior longitudinal ligament or an intercalary bone. However, this is a very characteristic appearance of congenitally elongated transverse processes of C5 and C6. This is a developmental variant with no clinical significance and should not be confused with any form of fracture. Congenital block vertebrae frequently present with fusion of the posterior facets, lamina, and spinous processes. This patient had no fusion of the facets or lamina. Of incidental notation is a small calcified nuchal bone present posterior to C6. This is not symptom generating.