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Osseous and vascular anatomical variations within the C1–C2 complex: a radiographical study using computed tomography angiography
Author(s) -
Moftakhar Parham,
Gonzalez Nestor R.,
Khoo Larry T.,
Holly Langston T.
Publication year - 2008
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.193
Subject(s) - medicine , vertebral artery , computed tomography angiography , angiography , radiology , foramen , tomography , computed tomography , transverse plane , nuclear medicine , anatomy
Background One of the limiting factors of C1–C2 fixation is the location of the vertebral artery (VA). The authors sought to assess the potential variations in atlanto–axial VA anatomy using computed tomography angiography (CTA). Methods Detailed measurements were made on digital images of 106 patients undergoing CTA at our institution (54 males, 52 females; mean age 56, range 20–86). Distances, diameters and angles of osseous and vascular elements of the atlanto–axial complex were measured. Results Optimal C1 and C2 screw trajectories demonstrated wide variations among patients. The size of the VA groove or foramen was not predictive of exact arterial location or size. Conclusions The size, location and path of the VA cannot be precisely predicted by the appearance of osseous structures such as the transverse foramina and/or the VA groove. CTA provides additional information regarding the atlanto–axial complex, and should be considered as a useful adjunct in the preoperative evaluation of select patients. Copyright © 2008 John Wiley & Sons, Ltd.