Document Detail


Anatomical variations of the vertebral artery segment in the lower cervical spine: analysis by three-dimensional computed tomography angiography.
MedLine Citation:
PMID:  18923317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Observational study with retrospective computerized tomography (CT) angiography analysis. OBJECTIVE: The purpose of this study is to examine the vertebral artery's course in the V2 segment and define the anatomic variations in the adult population using CT angiography. SUMMARY OF BACKGROUND DATA: The V2 segment of the vertebral artery (VA) usually extends from the transverse processes of C6-C2; however, the presence of abnormal VA course has been reported. These variations may predispose a patient to higher risk of iatrogenic vascular injury during anterior cervical surgery. METHODS: Retrospectively, 700 vertebral arteries on 350 three-dimensional CT angiographies were analyzed. Measurements were taken describing the relationship between the extraosseous portions of the VA to surgical landmarks. In addition, the diameter of the transverse foramen was measured on axial CT images. RESULTS: The VA entered the C6 transverse process in 94.9% of the specimens (664 out of 700 VA courses). Abnormal VA entrance was observed in 5.1% of the specimens (36 VA courses), with entrance into the C4, C5, or C7 transverse foramen 1.6%, 3.3%, and 0.3%, respectively.In 2 of 36 cases (5.6%) of abnormal VA entrance, the extraosseous VA formed an unusual medial loop, and the center of VA was positioned medial to the longus colli muscle. Furthermore, transverse foramens filled with VA were significantly larger than unfilled foramens (P < 0.01), but there was no significant difference between the C7 unfilled foraminal area and unfilled foraminal area above C7 (P = 0.768). CONCLUSION: The present study confirms the presence of anomalous VA routes in the V2 segment. A preoperativethree-dimensional computerized tomography (CT) angiography with axial images may be useful to identify the presence of an anomalous V2 route when suspected on magnetic resonance imaging or CT. Delineation of this anomaly may reduce the risk of intraoperative VA injury.
Authors:
Jae Taek Hong; Daniel K Park; Michael J Lee; Sang Woo Kim; Howard S An
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  33     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-16     Completed Date:  2008-12-12     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2422-6     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Angiography / methods*
Cervical Vertebrae / blood supply*
Female
Humans
Imaging, Three-Dimensional*
Male
Middle Aged
Radiographic Image Interpretation, Computer-Assisted*
Retrospective Studies
Tomography, X-Ray Computed*
Vertebral Artery / abnormalities,  radiography*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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