Three-dimensional computed tomography angiographic examine of the vertebral artery in sufferers with congenital craniovertebral junction anomalies.
Eur Backbone J. 2017 Apr;26(four):1028-1038
Authors: Sivaraju L, Mani S, Prabhu Okay, Daniel RT, Chacko AG
PURPOSE: To explain vertebral artery (VA) course on the C0-C1-C2 advanced in sufferers with congenital bony craniovertebral junction (CVJ) anomalies.
METHODS: We studied the course of 169 VAs in 86 sufferers with congenital bony CVJ anomalies [basilar invagination (42), os odontoideum (33), and irreducible atlantoaxial dislocation (11)]. Occipitalized atlas occurred in 41 sufferers (30 full and 11 partial). Utilizing axial, coronal and sagittal three-dimensional computed tomography (3D-CT) angiograms, we traced the VA bilaterally on the CVJ and correlated the course to the presence or absence of occipitalization of the atlas.
RESULTS: Of the 73 arteries related to occipitalization of atlas, all had an irregular course-58 (78.four %) coursed via a canal throughout the C0-C1 fused advanced and 15 (20.three %) coursed beneath the C1 posterior arch, and it was absent unilaterally in a single affected person. There have been 96 arteries related to a non-occipitalized atlas and solely 15 (15.three %) have been abnormal-eight coursed beneath the C1 posterior arch, 4 coursed above the C1 arch within the absence of a C1 foramen transversarium, one handed via a canal in C0-C1 and two arteries have been absent unilaterally. Sixty vertebral arteries (34 on the appropriate and 26 on the left facet) had a redundant loop located at a distance of ?5 mm from the C1 lateral mass in sufferers with os odontoideum and irreducible atlantoaxial dislocation.
CONCLUSIONS: In occipitalization of the atlas, the VA course is often abnormal-typically passing via a canal throughout the C0-C1 fused advanced or beneath the C1 arch. A redundant VA loop is extra more likely to be seen in os odontoideum and irreducible atlantoaxial dislocation. Cautious examine of the vertebral artery course with 3D CT angiography is obligatory whereas considering CVJ realignment surgical procedure in congenital anomalies of the CVJ.
PMID: 27137997 [PubMed – indexed for MEDLINE]