Radiological Study of Atlas Arch Defects with Meta-Analysis and a Proposed New Classification

This study consists of a retrospective cohort study, a systematic review, and a meta-analysis which were separately conducted. This study aimed to investigate the prevalence of atlas arch defects, generate an evidence-based synthesis, and propose a common classification system for the anterior and combined atlas arch defects. Atlas arch defects are well-corticated gaps in the anterior or posterior arch of the atlas. When both arches are involved, it is known as a combined arch defect. Awareness of these defects is essential for avoiding complications during surgical procedures on the upper spine. The prevalence of arch defects was investigated in an open-access OPC-Radiomics (Radiomic Biomarkers in Oropharyngeal Carcinoma) dataset comprising 606 head and neck computed tomography scans from oropharyngeal cancer patients. A systematic review and meta-analysis were performed to generate prevalence estimates of atlas arch defects and propose a classification system for the anterior and combined atlas arch defects. The posterior arch defect was found in 20 patients (3.3%) out of the 606 patients investigated. The anterior arch defect was not observed in any patient, while a combined arch defect was observed in one patient (0.2%). A meta-analysis of 13,539 participants from 14 studies, including the present study, yielded a pooled-posterior arch defect prevalence of 2.07% (95% confidence interval [CI], 1.22%–2.92%). The prevalences of anterior and combined arch defects were 0.00% (95% CI, 0.00%–0.10%) and 0.14% (95% CI, 0.04%–0.25%), respectively. The anterior and combined arch defects were classified into five subtypes based on their morphology and frequency. The present study showed that atlas arch defects were present in approximately 2% of the general population. For future studies, larger sample sizes should be used for studying arch defects to avoid the small-study effect and to predict the prevalence accurately.

Incidence and Skeletal Features of Developmental Cervical and Lumbar Spinal Stenosis

Methods@#A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4–C6) and third to fifth lumbar vertebrae (L3–L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses. @*Results@#The age was 22–93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the “no spinal stenosis sample,” DSS (−), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (p<0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum. @*Conclusions@#DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.

The laryngopharyngeal nerve: a comprehensive review / 대한해부학회지

The laryngopharyngeal nerve has received much less attention that the other contributions to the pharyngeal plexus i.e., glossopharyngeal and vagus nerves. Often, in descriptions and depictions, the nerve is simply labeled as the sympathetic contribution to the pharyngeal plexus. As there is such scant information available regarding this nerve, the present review was performed. Very little is found in the extant medical literature regarding the laryngopharyngeal nerve. However, based on available data, the nerve is a consistent contributory to the pharyngeal plexus and serves other adjacent areas e.g., carotid body. Therefore, a better understanding of this structure’s anatomy is important for those who operate in this area. Further studies are necessary to better elucidate the true function of the laryngopharyngeal nerve.

Innervation of pineal gland by the nervus conarii: a review of this almost forgotten structure / 대한해부학회지

The nervus conarii provides sympathetic nerve innervation to the pineal gland, which is thought to be the primary type of stimulus to this gland. This underreported nerve has been mostly studied in animals. One function of the nervus conarii may be to activate pinealocytes to produce melatonin. Others have also found substance P and calcitonin gene-related peptide from the nervus conarii ending in the pineal gland. The following paper reviews the extant medical literature on the nervus conarii including its anatomy and potential function.

An unusual arrangement between the highest denticulate ligament and posterior inferior cerebellar artery / 대한해부학회지

The posterior inferior cerebellar artery (PICA) is often involved in pathologies of the posterior cranial fossa. Therefore, a good understanding of the vessel’s normal and variant courses is important to the neurosurgeon or neurointerventionalist. During the routine microdissection of the craniocervical junction, an unusual arrangement between the highest denticulate ligament and PICA was observed. On the right side, the PICA was given rise to by the V4 segment of the vertebral artery 9 mm after the artery entered the dura mater of the posterior cranial fossa. The artery made an acute turn around the lateral edge of the highest denticulate ligament to then recur 180 degrees and travel medially toward the brainstem. Invasive procedures that target the PICA should be aware of the variant as described herein.

Pectorobrachioepicondylaris musculoaponeurotic band: case description with evidence of median nerve compression / 대한해부학회지

Upper limb muscle variations can be encountered on imaging or at surgery. We report an unusual muscle and band found during routine dissection of the arm in a cadaver. This case is described and salient literature reviewed. A band was found that traveled from the insertion of the pectoralis major tendon distally and obliquely toward the medial intermuscular septum and medical epicondyle. Fibers of the brachialis were found to interdigitate into the band. A tunnel was formed that carried the median nerve and brachial vessels. Evidence of median nerve compression was observed. We considered this an example of a pectorobrachioepicondylaris muscle. However, some can lead to clinical presentations. Although the significance of the case reported herein is not certain, signs of median nerve compression were identified. We believe that the term pectorobrachioepicondylaris bests describes the muscle reported herein and that our case represents a previously unreported variant of this muscle.

Anatomical Variation and Morphometric Study on Foramen Transversarium of the Upper Cervical Vertebrae in the Thai Population

Methods@#The FT and FA of dried C1 and C2 vertebrae (identified bones; n=107, males=53 and females=54) were observed and measured using a Digital Vernier Caliper (Mitutoyo, Kawasaki, Japan). Anteroposterior (AP) and transverse diameters of the left and right FTs (n=214) were measured and compared between sexes. Variations and types of FT and FA found on the upper vertebrae were recorded and classified. @*Results@#The FT shape of the Thai C1 was AP elliptical, while of that of C2 was transverse elliptical. Compared to females, both diameters of the upper spine were significantly greater in males except for the AP diameter of C2 on the right side. All diameters were significantly different in both sexes and sides except for the AP diameter of C1 and C2. A common type of FT classified in C1 was type 2 (male [69.81%], female [79.63%]) whereas for C2 it was type 1 (male [63.21%], female [59.26%]). Moreover, an incomplete osseous bridge was a major FA subtype observed in the Thai spine. @*Conclusions@#FT morphometry has an elliptical shape and diameters are greater in males. The FT and FA variations identified in this study will be useful for surgeons treating vertebral neurovascular injuries of the posterior upper cervical spine in the Thai population.

Gross and radiographic appearance of porotic hyperostosis and cribra orbitalia in thalassemia affected skulls / 대한해부학회지

Porotic hyperostosis (PH) is the expansion of the cranial diploë, generating ‘hair-on-end’ appearance on X-rays. This condition is extremely rare and had a prevalence of 0.08%. It is alternatively known as cribra orbitalia (CO) when the orbital roof is affected. In this study, we describe the gross morphology of two skulls affected by PH and CO. The first skull belonged to a 41-year-old female previously diagnosed with beta thalassemia. The skull was affected by excessive PH and CO. The second skull, belonging to a 35-year-old male diagnosed with unspecified thalassemia, showed PH without CO. The etiology of PH and CO is discussed. In conclusion, PH and CO are extremely rare, and are of significant importance for radiologists and anatomists when interpreting radiographs or encountering unusual gross morphology of the skull.

Gross and radiographic appearance of porotic hyperostosis and cribra orbitalia in thalassemia affected skulls / 대한해부학회지

Porotic hyperostosis (PH) is the expansion of the cranial diploë, generating ‘hair-on-end’ appearance on X-rays. This condition is extremely rare and had a prevalence of 0.08%. It is alternatively known as cribra orbitalia (CO) when the orbital roof is affected. In this study, we describe the gross morphology of two skulls affected by PH and CO. The first skull belonged to a 41-year-old female previously diagnosed with beta thalassemia. The skull was affected by excessive PH and CO. The second skull, belonging to a 35-year-old male diagnosed with unspecified thalassemia, showed PH without CO. The etiology of PH and CO is discussed. In conclusion, PH and CO are extremely rare, and are of significant importance for radiologists and anatomists when interpreting radiographs or encountering unusual gross morphology of the skull.

Assessment of risk of falling in community-dwelling elderly by using the

Falls are a cause of health problem and lead to disability or death in the elderly. Prevention of falls, especially in the high risk group, is thus important with the determination of overall risk factors. The Thai Fall Risk Assessment Tool (Thai FRAT) is a test for evaluating the risk of falls by considering both intrinsic and extrinsic risk factors. Meanwhile the Berg Balance Scale (BBS) emphasizes only the intrinsic factors. This study aimed to examine the agreement of the Thai FRAT and the BBS on identifying the risk of falls in 47 community-dwelling elderly (18 men and 29 women, mean age 76.3 ± 4.2 years) of Samliam Community, Khon Kaen Province. The agreement of the Thai FRAT and the BBS was analyzed by Kappa statistic. The result showed that the agreement of the Thai FRAT and the BBS on identifying the elderly at risk for falling was fair (K = 0.33, P = 0.009). This finding may indicate that physical therapists should apply the Thai FRAT and the BBS for assessing risk of falls of the elderly in community to obtain both intrinsic and extrinsic risk factors.