Cervical Myelopathy Accompanied With Hypoplasia of the Posterior Arch of the Atlas

Musha, Yoshiro; Mizutani, Kazuhiro

doi:10.1097/bsd.0b013e3181778181

Cited by 20 publications

(28 citation statements)

References 12 publications

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“…Musha and Mizutani 11) who used lateral roentgenograms for the identification of atlas hypoplasia in the Japanese population reported that the average sagittal inside diameter, equivalent to our IAP, was 34.4 mm in women and 37.1 mm in men. They defined hypoplasia as a value with 2 standard deviations (SD) below the standard.…”

Section: Discussionmentioning

confidence: 81%

“…Their findings suggest the IAP as the optimal parameter for defining atlas hypoplasia. 11,24) As IAP is strongly correlated with CSA (Tables 3 and 4) and IAP is easier to measure than CSA, we suggest that determining the IAP is appropriate for the assessment of atlas hypoplasia.…”

Section: Discussionmentioning

confidence: 86%

“…26–28) However, as they were primarily taken to determine surgical screw placement, measurements relating to hypoplasia are scarce. 11,24) To describe hypoplasia of the atlas, the parameters were the anterior-posterior diameter, the SCD, and the CSA of the atlas. 7–24) …”

Section: Discussionmentioning

confidence: 99%

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What Is the Most Representative Parameter for Describing the Size of the Atlas? CT Morphometric Analysis of the Atlas with Special Reference to Atlas Hypoplasia

Yamahata

Hirano

Yamaguchi

et al. 2017

Neurol. Med. Chir.(Tokyo)

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The spinal canal diameter (SCD) is one of the most studied factors for the assessment of cervical spinal canal stenosis. The inner anteroposterior diameter (IAP), the SCD, and the cross-sectional area (CSA) of the atlas have been used for the evaluation of the size of the atlas in patients with atlas hypoplasia, a rare form of developmental spinal canal stenosis, however, there is little information on their relationship. The aim of this study was to identify the most useful parameter for depicting the size of the atlas. The CSA, the IAP, and the SCD were measured on computed tomography (CT) images at the C1 level of 213 patients and compared in this retrospective study. These three parameters increased with increasing patient height and weight. There was a strong correlation between IAP and SCD (r = 0.853) or CSA (r = 0.822), while correlation between SCD and CSA (r = 0.695) was weaker than between IAP and CSA. Partial correlation analysis showed that IAP was positively correlated with SCD (r = 0.687) and CSA (r = 0.612) when CSA or SCD were controlled. SCD was negatively correlated with CSA when IAP was controlled (r = −0.21). The IAP can serve as the CSA for the evaluation of the size of the atlas ring, while the SCD does not correlate with the CSA. As the patient height and weight affect the size of the atlas, analysis of the spinal canal at the C1 level should take into account physiologic patient data.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 86%

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What Is the Most Representative Parameter for Describing the Size of the Atlas? CT Morphometric Analysis of the Atlas with Special Reference to Atlas Hypoplasia

Yamahata

Hirano

Yamaguchi

et al. 2017

Neurol. Med. Chir.(Tokyo)

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“…6–16,18,20–23 Musha and Mizutani measured the sagittal inside diameter (equivalent to our C1 anterior-posterior diameter) of 300 adult Japanese men and women. 18 They also defined hypoplasia as the lowest 2.5% of values. In women, 29.4mm was considered hypoplastic, while 30.5mm was hypoplastic in men.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several studies examining anatomy at the level of the atlas and axis. 17,18 These studies, however, have been underpowered, performed on radiographs, or both. No adequately powered study exists to define hypoplasia of the atlas.…”

Section: Introductionmentioning

confidence: 99%

Defining Hyoplasia of the Atlas

Kelly

Oshima

Yeom

et al. 2014

Spine

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Study Design Cadaveric Study Objective To define congenital hypoplasia of the atlas. Summary of Background Data Little has been written about hypoplasia of the atlas and it is usually described in the setting of other skeletal dysplasias or syndromes. Methods 543 Cervical spine specimens were randomly selected from the Hamann Todd Collection. Sagittal and coronal diameters of the atlas, axis, and C3 (when available) and the dens diameter were measured using digital calipers. Correction for modern size and radiographic magnification was performed. Hypoplasia of the atlas was defined as the lowest 2.5% of measurements. The correlation between inner sagittal diameters at C1 and C3 was calculated. Results The mean C1 inner sagittal diameter was 30.8 ± 2.4mm (Range 23.5 – 38.1mm). We defined C1 hypoplasia as an inner sagittal diameter value representing the smallest 2.5% of subjects. Since the mean was 30.8mm, hypoplasia was defined as a diameter ≤ 26.1mm. Correcting for size and magnification of radiographs, hypoplasia is defined as an inner sagittal diameter of the atlas of 28.9 mm. Approximately 10% of cases had a dens that occupied more than 40% of the spinal canal at C1, thus not following Steel’s Rule of Thirds. There was only a moderate correlation between the spinal canal diameter at C1 and at C3 (r=0.483, N=345, P<0.001). Conclusions With an inner sagittal diameter of 26mm or less, one may describe the atlas as hypoplastic. 10% of the specimens had an odontoid process that occupied more than 40% of the spinal canal at C1. There was little correlation between the inner sagittal diameter at C1 and the diameter at C3.

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Variation of C1 spinolaminar line and prevalence of C1 stenosis in normal population

Kunakornsawat

Letho

Pluemvitayaporn

et al. 2018

Eur J Orthop Surg Traumatol

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Cervical Myelopathy Accompanied With Hypoplasia of the Posterior Arch of the Atlas

Cited by 20 publications

References 12 publications

What Is the Most Representative Parameter for Describing the Size of the Atlas? CT Morphometric Analysis of the Atlas with Special Reference to Atlas Hypoplasia

What Is the Most Representative Parameter for Describing the Size of the Atlas? CT Morphometric Analysis of the Atlas with Special Reference to Atlas Hypoplasia

Defining Hyoplasia of the Atlas

Variation of C1 spinolaminar line and prevalence of C1 stenosis in normal population

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