The vertebral column can have many anatomic defects. One of the rarer vertebral defect is the block vertebrae in which two adjacent vertebrae can be fused. This is a classic example of metamerism in human body. These two vertebrae appear as Anatomically one vertebrae. The fusion can be right from the birth or can be acquired defect. There may be associated Myelopathy, Muscular weakness, Klippel Feil Deformity, Rheumatoid arthritis, Tuberculosis, scoliosis or trauma, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, fibrous dysplasias , rickets.