Anatomical Variation and Morphometric Study on Foramen Transversarium of the Upper Cervical Vertebrae in the Thai Population

다국어 초록 (Multilingual Abstract)

Study Design: Foramen transversarium (FT) and foramen arcuale (FA) of upper cervical vertebrae (C1 and C2) in the Thai population were investigated for variation and morphometry.
Purpose: This study aimed to reveal the morphometry of FT and FA in the Thai population.
Overview of Literature: The FT and FA are structures found in the upper spine that support the vertebral neurovascular system. Clinically, the surgical approaches to achieve upper cervical stability can be affected by spine variations. FT and FA morphometries have been documented to vary by nationality. However, such reports have been limited in the Thai population.
Methods: The FT and FA of dried C1 and C2 vertebrae (identified bones; n=107, males=53 and females=54) were observed and measured using a Digital Vernier Caliper (Mitutoyo, Kawasaki, Japan). Anteroposterior (AP) and transverse diameters of the left and right FTs (n=214) were measured and compared between sexes. Variations and types of FT and FA found on the upper vertebrae were recorded and classified.
Results: The FT shape of the Thai C1 was AP elliptical, while of that of C2 was transverse elliptical. Compared to females, both diameters of the upper spine were significantly greater in males except for the AP diameter of C2 on the right side. All diameters were significantly different in both sexes and sides except for the AP diameter of C1 and C2. A common type of FT classified in C1 was type 2 (male [69.81%], female [79.63%]) whereas for C2 it was type 1 (male [63.21%], female [59.26%]). Moreover, an incomplete osseous bridge was a major FA subtype observed in the Thai spine.
Conclusions: FT morphometry has an elliptical shape and diameters are greater in males. The FT and FA variations identified in this study will be useful for surgeons treating vertebral neurovascular injuries of the posterior upper cervical spine in the Thai population.

참고문헌 (Reference)

1 Nagar Y, "What can we make of these fragments? : excavation at ‘Mamilla’ cave, Byzantine period, Jerusalem" 9 : 29-38, 1999

2 Gupta SC, "The retrotransverse groove(canal)in the Indian atlas vertebrae" 145 : 514-516, 1979

3 Veleanu C, "The retrotransverse groove or canal of the atlas and its significance" 97 : 400-402, 1977

4 Lamberty BG, "The retro-articular vertebral artery ring of the atlas and its significance" 85 : 113-122, 1973

5 Abdul RS, "The foramen transversarium of typical and atypical cervical vertebrae : morphology and morphometry" 36 : 1439-1446, 2018

6 Hridayesh Pratap Malla, "Study of the Transverse Foramen in the Subaxial Cervical Spine in Korean Patients With Degenerative Changes: An Anatomical Note" 대한척추신경외과학회 15 (15): 163-168, 2018

7 Karau PB, "Some anatomical and morphometric observations in the transverse foramina of the atlas among Kenyans" 2 : 61-66, 2013

8 Kimura K, "Shape and size of the transverse foramina in Japanese" 62 : 123-131, 1985

9 Sanchis-Gimeno JA, "Retrotransverse foramen of the atlas : prevalence and bony variations" 27 : 1272-1277, 2018

10 Quiles-Guinau L, "Retrotransverse foramen in atlas vertebrae of the late 17th and 18th centuries" 121 : 123-132, 2016

11 Pekala PA, "Prevalence of foramen arcuale and its clinical significance : a meta-analysis of 55, 985 subjects" 27 : 276-290, 2017

12 Travan L, "Normal anatomy and anatomic variants of vascular foramens in the cervical vertebrae : a paleoosteological study and review of the literature" 90 : 308-323, 2015

13 Patel NP, "Incidence of ponticles in human atlas vertebrae : a study from South Gujarat population" 2 : 135-139, 2015

14 Paraskevas GK, "Incidence and purpose of the clival canal, a"neglected"skull base canal" 155 : 139-140, 2013

15 Paraskevas G, "Gross morphology of the bridges over the vertebral artery groove on the atlas" 27 : 129-136, 2005

16 Tubbs RS, "Foramen arcuale : anatomical study and review of the literature" 6 : 31-34, 2007

17 Cirpan S, "Foramen arcuale : a rare morphological variation located in atlas vertebrae" 39 : 877-884, 2017

18 Kaya S, "Double foramen transversarium variation in ancient Byzantine cervical vertebrae : preliminary report of an anthropological study" 21 : 534-538, 2011

19 Das S, "Double foramen transversaria : an osteological study with clinical implications" 12 : 311-313, 2005

20 Sangari SK, "Dimensions and anatomical variants of the foramen transversarium of typical cervical vertebrae" 2015 : 391823-, 2015

21 Cakmak O, "Arcuate foramen and its clinical significance" 26 : 1409-1413, 2005

22 Bodon G, "Applied anatomy of screw placement via the posterior arch of the atlas and anatomy-based refinements of the technique" 26 : 793-803, 2016

23 Zibis AH, "Anatomical variations of the foramen transversarium in cervical vertebrae : findings, review of the literature, and clinical significance during cervical spine surgery" 25 : 4132-4139, 2016

24 Guerra MM, "Anatomical variations of the foramen transversarium in cervical vertebrae" 35 : 719-722, 2017

25 Taitz C, "Anatomical observations of the foramina transversaria" 41 : 170-176, 1978

26 Yadav Y, "An osteological study of foramen trasversarium : variations and clinical aspects" 3 : 14562-14566, 2014

27 Mahiphot J, "A morphometric study on subaxial cervical pedicles of Thai people" 44 : E579-84, 2019