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En la vertebra atlas, los puentes posteriores, los puentes laterales y los tuneles postero-laterales son las protrusiones oseas que pueden causar presion externa en la arteria vertebral cuando pasa  del foramen transverso de la vertebra cervical al foramen magnum del craneo. Ejemplares que muestran dichas protrusiones fueron clasificadas segun tengan puentes del atlas completos o incompletos que pueden predisponer a la insuficiencia vertebrobasilar y al sindrome cervicogenico especialmente durante los movimientos de cuello. El objetivo del estudio es saber la incidencia, ontogenia y filogenia de los puentes del atlas junto con las implicaciones clinicas. Este canal de la arteria vertebral del atlas y la morfologia de los puentes fueron estudiados en un total de 60 (120 lados) vertebras atlas humanas completas y secas obtenidas de la coleccion de esqueletos del Departamento de Anatomia del Government Medical College de Amritsar en Punjab. La incidencia de la impresion de la arteria vertebral (44), la impresion profunda de la arteria vertebral (42) era 71,66%, el puente parcial fue 13,33% y el puente lateral parcial fue 3,33% en el lado derecho y 5% en lado izquierdo. Tambien se observaron doce anillos completos y un tunel 1.66% postero-lateral. La ocurrencia de estos puentes oseos abrazando la arteria vertebral es de suma importancia clinica, pueden causar efecto de comprension en la arteria vertebral durante la rotacion extrema de la cabeza y movimientos de cuello manifestandose en mareos, desmayos, diplopia temporal, vertigo y desordenes neurologicos. El conocimiento de esta variacion es importante para medicos, otorrinolaringologos, neurologos y ortopedistas que en la practica diaria estan en contacto con estas enfermedades de la columna vertebral y sus consecuencias.  In atlas vertebrae, the posterior bridges, lateral bridges and postero-lateral tunnels are the bony outgrowths which may cause external pressure on the vertebral artery when it passes from foramen transversarium of the cervical vertebra to foramen magnum of the skull. Specimens exhibiting such outgrowths were classified as having incomplete or complete atlas bridges that may predispose to vertebro-basilar insufficiency and cervicogenic syndrome especially in neck movements. The objective of the study is to know the incidence, ontogeny and phylogeny of atlas bridges along with its clinical implications. The groove of the vertebral artery of the atlas and the morphology of the bridges were studied in a total of 60 (120 sides) complete and dry human atlas vertebrae obtained from the skeletal collection of Department of Anatomy,GovernmentMedicalCollege,Amritsar,Punjab.  The incidence of impression of vertebral artery (44), deep impression of vertebral artery (42) was 71.66%, Partial ponticuli were 13.33% and Partial lateral ponticuli were 3.33% on right side and 5% on left side. Twelve complete rings and one 1.66% postero-latetal tunnel was also observed. Occurrence of these bony bridges embracing the vertebral artery is of great clinical importance, may cause compression effect on the vertebral artery during extreme rotation of head and neck movements presenting with dizziness, fainting, transient diplopia, vertigo and neurological disturbances. The knowledge of this variation is important for physicians, otolaryngologists, neurologists and orthopaedicians who in every day practice are in contact with the diseases of spine and their consequences.

revista argentina de anatomía clínica

INCIDENCE OF ATLAS BRIDGES AND TUNNELS – THEIR PHYLOGENY, ONTOGENY AND CLINICAL IMPLICATIONS. 26 Incidencia de los puentes y túneles del atlas – Su filogenia, ontogenia e implicancias clínicas