Morphologic and Radiologic Anatomy of the Occipital Bone

Naderi, Sait; Usal, Can; Tural, Ahmet; Korman, Esin; Mertol, Tansu; Arda, M. Nuri

doi:10.1097/00002517-200112000-00006

Cited by 17 publications

(20 citation statements)

References 5 publications

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“…[3711] The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT) to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in patients from this region.…”

Section: Introductionmentioning

confidence: 99%

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

King

Tiruchelvarayan

et al. 2014

Surg Neurol Int

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Background:Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT) to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population.Methods:Thirty patients undergoing cranio-cervical junction instrumentation during the period 2008-2010 were included. The thickness of the occipital bone and the length and diameter of the C2 pedicle were measured based on CT.Results:The thickest point on the occipital bone was in the midline with a maximum thickness below the external occipital protuberance of 16.2 mm (±3.0 mm), which was thicker than in the Western population. The average C2 pedicle diameter was 5.3 mm (±2.0 mm). This was smaller than Western population pedicle diameters. The average length of the both pedicles to the midpoint of the C2 vertebral body was 23.5 mm (±3.3 mm on the left and ±2.3 mm on the right).Conclusions:The results of this first study in the South East Asian population should help guide and improve the safety in occipito-cervical region instrumentation. Thus reducing the risk of technical failures and neuro-vascular injury.

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Section: Introductionmentioning

confidence: 99%

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

King

Tiruchelvarayan

et al. 2014

Surg Neurol Int

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“…This difference is also found in lateral points (Table 3). This midline and paramedian bone offers the best purchase for screws and is commonly used in most OCF instrumentation systems [5,8,12]. Moreover, the screws are also placed into the region of the fossa cerebellaris [13], where the bone offers a thickness of only about 3 mm.…”

Section: Resultsmentioning

confidence: 99%

Computed Tomographic Morphometric Study of the Occipital Bone Thickness in 100 Adult, Moroccan Patients

Hilmani¹,

Trezor²

2016

J Spine

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Background: Occipital cervical fixation (OCF) is an important and difficult technic and has certain risks due to its relation with adjacent special anatomic features. One of specific areas to perform screw fixation and to prevent technical failures is the thickness of the occipital bone which require detailed morphological anatomical knowledge. To our knowledge, no published study has provided thicknesses of occiput in African Continent.

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“…Ebraheim et al 3 reported that 8-mm screws should be inserted up to 2 cm lateral from the midline at the level of the EOP, 1 cm from the median crest at a level 1 cm inferior to the protuberance, and 0.5 cm from the crest at a level 2 cm inferior to the protuberance. Hertel and Hirschfelder 10 and Naderi et al 14 reported that the area > 8 mm thick was up to 1 cm lateral to the EOP at the level of the superior nuchal line and 2 cm inferior to the EOP. In our study, the area was 2 cm lateral to the EOP at the level of the superior nuchal line and 3 cm inferior to the EOP.…”

Section: Discussionmentioning

confidence: 98%

“…6,10,14,17,23 For instance, Grob et al, 6 who used CT, reported average thicknesses of 14 mm at the center of the superior nuchal line, 6.6 mm at the right paramedian, and 5.7 mm at the left paramedian. Moreover, these authors recommended inserting the screw at the median of the occipital bone.…”

Section: Discussionmentioning

confidence: 99%

Mapping occipital bone thickness using computed tomography for safe screw placement

Morita¹,

Takebayashi²,

Takashima³

et al. 2015

SPI

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OBJECT Safe and effective insertion of occipital bone screws requires morphological analysis of the occipital bone, which is poorly documented in the literature. The authors of this study present morphological data for determining the area of screw placement for optimal internal fixation. METHODS The subjects of this institutional review board-approved retrospective study were 105 individuals without head and neck disease who underwent CT imaging at the authors’ hospital. There were 55 males and 50 females, with a mean age of 57.1 years (range 20–91 years). Measurements using CT were taken according to a matrix of 55 points following a grid with 1-cm spacing based on the external occipital protuberance (EOP). RESULTS The maximum thickness of the occipital bone was at the level of the EOP at 16.4 mm. Areas with thicknesses > 8 mm were more frequent at the EOP and up to 2 cm in all directions, as well as up to 1 cm in all directions at a height of 1 cm inferiorly, and up to 3 cm from the EOP inferiorly. The male group tended to have a thicker occipital bone than the female group, and the differences were significant around the EOP. The ratio of the trabecular bone to the occipital bone thickness was > 30% in the central region. At positions more than 2 cm laterally, the ratio was < 15%, and the ratio gradually decreased further laterally. CONCLUSIONS Screws that are 8 mm long can be placed in the area extending 2 cm laterally from the EOP at the level of the superior nuchal line and approximately 3 cm inferior to the center. These results suggest that it may be possible to effectively insert a screw over a wider area than the conventional reference range.

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Morphologic and Radiologic Anatomy of the Occipital Bone

Cited by 17 publications

References 5 publications

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

Computed Tomographic Morphometric Study of the Occipital Bone Thickness in 100 Adult, Moroccan Patients

Mapping occipital bone thickness using computed tomography for safe screw placement

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