Document Detail

Incidence and Risk Factors of the Retropharyngeal Carotid Artery on Cervical Magnetic Resonance Imaging.
MedLine Citation:
PMID:  23124269     Owner:  NLM     Status:  Publisher    
Study Design. Retrospective cohortObjective. Define incidence of anomalous carotid vasculature and associated risk factors as pertains to the anterior approach.Summary of Background Data. The carotid artery system, including the common, internal, and external branches, is lateral to the foramen transversarium. If unrecognized, aberrancies in carotid vessel anatomy can lead to devastating complications.Methods. 1000 cervical MRIs were screened to localize the carotid artery respective to medial/ lateral location of the vessel at each segment from C2/3 to C6/7 bilaterally. Vessel location was classified in 3 zones: lateral to the vertebral foramen (Type I) (normal); between the lateral foramen and uncoverterbral joint (Type II); and medial to the uncovertebral joint (Type III). Type III locations were compared to age matched controls for assessment of cervical alignment via the Ishihara index, C2-C7 angle, as well as degree of spondylosis.Results. 123 patients demonstrated carotid artery anomalies (Type II and III) (12.3%). 26 patients had Type III aberrancy (2.6%). Patients with anomalies were significantly older and more likely female than all other patients (60 vs. 51 years of age, 74% vs. 57% female, respectively, p < 0.05). The Type III group average age was 66.1 years and 88% were female. Aberrancies were more likely right-sided and at C3-4 or cranial. C2-7 angle showed significantly greater kyphosis in patients with anomalies compared to controls (6.2 vs. 14.4, p 0.03). The amount severely spondolytic segments was significantly greater in patients with Type III locations compared to controls (2.0 vs. 1.1, p <0.05).Conclusion. Carotid arterial anomalies occurred in 12.3% of cases; severe aberrancy was present in 2.6% of patients. In elderly females with kyphotic alignment, a high index of suspicion must be raised for aberrancy. Preoperative assessment of the vasculature in the anterior neck may avoid catastrophic complications.
Jason Koreckij; Robert Gibly; Eric Pang; Wellington K Hsu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-2
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Columbia Orthopaedic Group, 1 South Keene Street, Columbia, MO 65203 Northwestern University - Dept Orthopedic Surgery Assistant Professor in Orthopedic Surgery Northwestern University School of Medicine Northwestern Memorial Hospital.
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