OBJECTIVE: To discuss an interesting case depicting multiple levels of cervical spondylolysis. Differential diagnosis and a brief review of the literature are discussed.

CLINICAL FEATURES: A 24-yr-old man suffered from constant neck discomfort of approximately 4 months' duration. After physical examination, X-rays were performed and revealed multiple congenital anomalies. The patient's symptoms are considered independent of the radiographic findings.

INTERVENTION AND OUTCOME: This patient was successfully treated with conservative chiropractic management and experienced complete resolution of his presenting symptoms.

CONCLUSION: This case nicely demonstrates the congenital nature of cervical spondylolysis. It is unusual in that no prior case report has described three levels of involvement. The spondylolysis and other changes of the neural arch should not be confused with fracture.

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