Cervical spine pneumatocysts in cone beam CT scan volumes: Looking beyond the Jaws

Pneumatocysts are benign lesions often detected by accident during full-FOV CBCT imaging. They appear as tiny, well-circumscribed, radiolucent lesions with a sclerotic rim. Dentists are likely to view this lesion on CBCT scans because of the growing use of this imaging modality in dentistry to assess maxillofacial structures. Identifying the pathognomonic characteristics of this benign, innocuous lesion is critical to prevent pointless studies and patient alarm. This study aimed to determine the prevalence of pneumatocysts in the cervical spine and correlate it with age and sex. Large field-of-view computed tomography (CBCT) volumes in the radiology archives (338 total scans) were screened for vertebral pneumatocysts. When observing pneumatocysts on the scan, the number of pneumatocysts and the vertebra in which they were present were noted. Among the 338 patients, eight had pneumatocysts. We found no sex correlation but a definite correlation with age; the prevalence of pneumatocysts also increased as age increased. Pneumatocysts in the cervical spine are rare. In our eight cases, these intravertebral pneumatocysts were discovered as unintentional findings on CBCT scans performed for dentomaxillofacial diagnostic purposes. To our knowledge, few studies have investigated these lesions via CBCT. • Novel Findings: The study identifies the prevalence of pneumatocysts in the cervical spine, noting an increase with age. Using Full FOV CBCT Scans of 338 patients. • Results: Found pneumatocysts in 8 patients, with no correlation to sex but a clear correlation to age. • Clinical Implications: Important to recognize pneumatocysts to avoid Misdiagnosis Clinical Implications - Pneumatocysts are often incidentally identified on radiographs and should not be mistaken for osteolytic lesions, which can lead to unnecessary delays in implant placement. Understanding these benign, gas-containing lesions is crucial from a clinical standpoint. With the growing use of Cone Beam Computed Tomography (CBCT) in dentistry for assessing maxillofacial structures before implant procedures, dentists are likely to encounter these lesions in scans that include the superior cervical spine. It is essential to recognize the distinctive features of this benign condition to prevent unwarranted postponements in implant cases.