The effect of posterior bridging of C-1 on craniovertebral junction surgery

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  • 1 Departments of Neurosurgery, Anatomy, Orthopaedics, and Family Medicine, Kahramanmaras Sutcuimam University Medical School, Kahramanmaras, Turkey
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Object

The groove for the vertebral artery (VA) may be bridged on C-1, forming a canal through which the artery passes. Because this variant may significantly affect the commonly performed C-1 posterior laminectomy, the authors studied the incidence and radiological appearance of this anatomical feature in surgical specimens.

Methods

Anatomical measurements were performed using a Vernier caliper (accurate to 0.1 mm) on 166 dry C-1 vertebrae. In addition, a convenience sample of 172 cervical x-ray films was evaluated. Partial osseous bridging was detected in eight (4.8%), and a complete osseous bridge, forming the canalis arteriae vertebralis (canal for the VA), was seen unilaterally (eight on the left and two on the right) in 10 (6%) and bilaterally in eight (4.8%) of the dry vertebrae. On lateral radiography, a complete bone bridge was observed on nine (5.2%) and a partial bridge on 10 (5.8%) of the 172 studies.

Conclusions

The discovery of a common variant may necessitate an immediate change in surgical management, and this anomaly could even increase the rate of surgery-related complications. The VA canal, present in the C-1 vertebra in approximately 5% of the specimens evaluated, was a variant that may be protective against VA injury. Knowledge of this variant may help the surgeon undertaking procedures in the C-1 region.

Abbreviations used in this paper:

CT = computed tomography; CVJ = craniovertebral junction; VA = vertebral artery; 3D = three-dimensional.

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