[Radiologic case of the month. Disk calcinosis in the child]

Herniation of a calcified cervical disc into the foramen transversarium in an 8-year-old child

STUDY DESIGN

Herniation of a calcified C3-C4 disc into the left foramen transversarium in a child is reported.

OBJECTIVE

To discuss the natural history and management of a calcified disc herniation into the foramen transversarium.

SUMMARY OF BACKGROUND DATA

Cervical disc calcification in children usually follows a benign course. Herniation of the calcified disc into the spinal canal has already been described. However, herniation into the foramen transversarium has never been reported.

METHODS

An 8-year-old girl presented with progressive neck pain and torticollis. Her neurologic examination was normal. She was treated using a head halter traction, analgesics, and muscle relaxants for 3 days, followed by the use of a soft cervical collar for 2 weeks.

RESULTS

Computed tomography scan showed a calcified C3-C4 disc with herniation into the C3 left foramen transversarium. Her symptoms subsided and she rapidly regained full range of motion of her neck after 3 days of conservative treatment. Magnetic resonance angiography done after 2 months did not show any residual compression of the left vertebral artery. After 3 months, the herniation had completely disappeared, whereas only a small central calcification remained in the C3-C4 disc space.

CONCLUSION

The natural history of cervical disc calcification is usually benign. A computed tomography scan can be performed for patients in whom a calcified disc herniation is suspected on the plain films. In this case of herniation into the foramen transversarium, magnetic resonance angiography was useful to evaluate the integrity of the vertebral arteries. Spontaneous resolution of the herniated disc and return to normal function can be expected with conservative treatment.