Congenital agenesis of a lumbar vertebral pedicle is an exceptionally rare developmental anomaly that is often detected incidentally during imaging performed for unrelated clinical indications. Although most cases remain asymptomatic, accurate recognition is essential to prevent misinterpretation as traumatic, infectious, or neoplastic pathology and to avoid potential complications during spinal interventions. We report an incidental finding of unilateral right L5 pedicle agenesis in a 42-year-old woman who underwent contrast-enhanced computed tomography of the abdomen for evaluation of abdominal pain and loose stools. Abdominal findings were unremarkable; however, axial and multiplanar reformatted images revealed complete absence of the right pedicle of the L5 vertebra. The right transverse process was anomalously positioned, arising directly from the vertebral body rather than from the pedicle, representing a rare anatomical variant. The vertebral body, posterior elements, and neural arch were otherwise intact, with no evidence of spondylolisthesis, spinal canal compromise, nerve root compression, or adjacent degenerative changes. The patient had no history of back pain, radiculopathy, neurological deficits, or prior spinal disease. Imaging features were consistent with a benign congenital anomaly rather than an acquired destructive process. This case highlights a rare lumbar spine variant and underscores the importance of recognizing congenital pedicle agenesis and associated osseous alterations on CT imaging. Awareness of such entities is crucial for radiologists and spine surgeons to avoid diagnostic errors, unnecessary investigations, and inadvertent complications during surgical planning or spinal instrumentation.
Keywords: Pedicle agenesis; Congenital spinal anomaly; Lumbar spine; Computed tomography; Surgical planning
How to cite this article: Kushwaha H, Prasanth V, Computed Tomographic Identification of Congenital Right L5 Pedicle Agenesis with Vertebral Body–Based Ectopic Transverse Process. Int J Drug Deliv Technol. 2026;16(5s): 270-273; DOI: 10.25258/ijddt.16.5s.34
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