Volume : VII, Issue : V, May - 2017

Morphometric Analysis Of Axis Vertebra And Its Implications For Instrumentation

Poongodi. S, Baba Dhoulath Khan H. M

Abstract :

 INTRODUCTION–             The anatomy  of  second  cervical  vertea  and its  normal  variation in  anatomy  and thin section CT analysis has  important  implications  for  instrumentation  of  upper cervical  verteae particularly the transarticular screw fixation at C1–C2 level that provides a rigid fixation. The aims of this study is to to study  the anatomical  variations  of the pedicle,the lateral  mass, the verteal artery groove and the  transverse  foramen  parameters of axis  vertea  in dry  bone  and to study  the  CT morphometry  of  axis  vertea  and further to emphasize  that  high  resolution  CT  with  3  dimensional  reconstruction  is  mandatory  before  instrumentation to  stabilise the C1  to  C2 segment. MATERIALS AND METHODS 25 dry  specimens  of  the  second  cervical  vertea  were  obtained from the  Department  of  Anatomy, Madurai  Medical  College  Madurai. Nine  parameters mainly of the  pedicle, the  lateral  mass, the groove  for  the  verteal  artery and  the  transverse  foramen  were  measured  and  all  were  linear  dimensions.  The   mean,  standard  deviation  and  range  were  calculated  for  all  25  specimens  amounting  to  a  total  of  50 measurements  for  each  observation.  The data  of  patients   undergoing  CT  of the neck with thinly   sliced  1 mm  sections  and MPR in sagittal and coronal planes were  obtained  through  the   region  of  interest  from  the  base  of  C3  to  C1–C0  joint and  five  CT  morphometric  parameters  were  used   to provide the surgeons the data regarding the lateral mass and the depth of the verteal artery groove and to help them avoid an enlarged verteal groove. RESULTS The morphometric analysis and measurement of  the mean height of the pedicle, width of the pedicle, length of the lateral mass, external height of lateral mass,depth of verteal artery groove, internal Height of Lateral Mass, length of VA Groove, height of transverse foramen ,width of transverse foramen, external height of lateral mass (CT) ,depth of Verteal artery Groove (CT) ,internal Height of Lateral Mass (CT), length of VA Groove (CT) ,height of transverse foramen (CT) was done and tabulated. This study has focussed on the anatomical features of the vertea of C2 which are important in the instrumental stabilization of C1 to C2.  Variations in the course of the verteal artery  through C2 has been described before in case reports, in dried specimens,  by CT and in cadavers. CONCLUSIONS Thinning of the lateral mass and the pedicle of axis vertea due to the verteal artery may prevent adequate fixation by posterior transarticular screw placement.  High resolution thin section CT scanning to analyze verteal artery to prevent verteal artery injury is recommended for this purpose which can be further improved by intraoperative flouroscopy and and by avoiding the procedure in anatomically unsuitable cases.High resolution CT with 3–D reconstruction is mandatory before screw fixation is used to stabilize the C1 to C2 segment.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Poongodi.S, Baba Dhoulath Khan H.M, Morphometric Analysis Of Axis Vertebra And Its Implications For Instrumentation, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾5 | May‾2017

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