Abstract
Goldenhar syndrome has reported incidence ranging from 1:3500 to 1:20000 live births. It consists of abnormalities involving the first and the second branchial arches and its etiology is heterogenous. A newborn with this condition can have a normal life and intelligence, so it is important to correctly diagnose and manage the various conditions associated with Goldenhar syndrome to preserve patient quality of life. This case report describes a unique vertebral abnormality in a patient with Goldenhar syndrome, where a lumbar nerve root or vessel traverses an anomalous vertically oriented osseous foramen in a lumbar spine pedicle. If this anomaly goes unidentified, pedicle screw placement may pose a significant surgical risk to the traversing nerve or vessel.