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
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,...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2019-04-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2018-0057.pdf |
| _version_ | 1818036014869905408 |
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| author | Manish Kundanmal Kothari Samir Surendranath Dalvie Santosh Gupta Agnivesh Tikoo Deepak Kumar Singh |
| author_facet | Manish Kundanmal Kothari Samir Surendranath Dalvie Santosh Gupta Agnivesh Tikoo Deepak Kumar Singh |
| author_sort | Manish Kundanmal Kothari |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T07:04:13Z |
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| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-10T07:04:13Z |
| publishDate | 2019-04-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-e9f5716c63464772a4607f9bae3772a42022-12-22T01:58:15ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462019-04-0113229029510.31616/asj.2018.00571015The C2 Pedicle Width, Pars Length, and Laminar Thickness in Concurrent Ipsilateral Ponticulus Posticus and High-Riding Vertebral Artery: A Radiological Computed Tomography Scan-Based StudyManish Kundanmal Kothari0Samir Surendranath Dalvie1Santosh Gupta2Agnivesh Tikoo3Deepak Kumar Singh4 Department of Orthopaedics, Jaslok Hospital & Research Centre, Mumbai, India Department of Orthopaedics, P D Hinduja National Hospital & MRC, Mumbai, India Department of Radiology, P D Hinduja National Hospital & MRC, Mumbai, India Department of Orthopaedics, P D Hinduja National Hospital & MRC, Mumbai, India Department of Orthopaedics, P D Hinduja National Hospital & MRC, Mumbai, IndiaStudy 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.http://www.asianspinejournal.org/upload/pdf/asj-2018-0057.pdfPonticulus posticusHigh-riding vertebral arteryAxis, cervical vertebraCervical atlas |
| spellingShingle | Manish Kundanmal Kothari Samir Surendranath Dalvie Santosh Gupta Agnivesh Tikoo Deepak Kumar Singh 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 Ponticulus posticus High-riding vertebral artery Axis, cervical vertebra Cervical atlas |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Ponticulus posticus High-riding vertebral artery Axis, cervical vertebra Cervical atlas |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2018-0057.pdf |
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