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The C2 Pedicle Width, Pars Length, and Laminar Thickness in Concurrent Ipsilateral Ponticulus Posticus and High-Riding Vertebral Artery: A Radiological Computed Tomography Scan-Based Study
Asian Spine Journal ; : 290-295, 2019.
Article in English | WPRIM | ID: wpr-762923
Responsible library: WPRO
ABSTRACT
STUDY

DESIGN:

Retrospective radiological study.

PURPOSE:

We aimed to determine the prevalence of ponticulus posticus (PP) and high-riding vertebral artery (HRVA) occurring simultaneously on the same side (PP+HRVA) and in cases of PP+HRVA, to assess C2 radio-anatomical measurements for C2 pars length, pedicle width, and laminar thickness. OVERVIEW OF LITERATURE PP and HRVA predispose individuals to vertebral artery injuries during atlantoaxial fixation. In cases of PP+HRVA, the construct options thus become limited.

METHODS:

Consecutive computed tomography scans (n=210) were reviewed for PP and HRVA (defined as an internal height of <2 mm and an isthmus height of <5 mm). In scans with PP+HRVA, we measured the ipsilateral pedicle width, pars length, and laminar thickness and compared them with controls (those without PP or HRVA).

RESULTS:

PP was present in 14.76% and HRVA in 20% of scans. Of the 420 sides in 210 scans, PP+HRVA was present on 13 sides (seven right and six left). In scans with PP+HRVA, the C2 pars length was shorter compared with controls (13.69 mm in PP+HRVA vs. 20.65 mm in controls, p<0.001). The mean C2 pedicle width was 2.53 mm in scans with PP+HRVA vs. 5.83 mm in controls (p<0.001). The mean laminar thickness was 4.92 and 5.48 mm in scans with PP+HRVA and controls, respectively (p=0.209).

CONCLUSIONS:

The prevalence of PP+HRVA was approximately 3% in the present study. Our data suggest that, in such situations, C2 pedicle width and pars length create important safety limitations for a proposed screw, whereas the translaminar thickness appears safe for a proposed screw.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Cervical Atlas / Axis, Cervical Vertebra / Vertebral Artery / Prevalence / Retrospective Studies Type of study: Prevalence study Language: English Journal: Asian Spine Journal Year: 2019 Type: Article
Full text: Available Index: WPRIM (Western Pacific) Main subject: Cervical Atlas / Axis, Cervical Vertebra / Vertebral Artery / Prevalence / Retrospective Studies Type of study: Prevalence study Language: English Journal: Asian Spine Journal Year: 2019 Type: Article