Variance of Cervical Vertebral Artery Measured by CT Angiography and Its Influence on C7 Pedicle Anatomy

Wakao, Norimitsu; Takeuchi, Mikinobu; Kamiya, Mitsuhiro; Aoyama, Masahiro; Hirasawa, Atsuhiko; Sato, Keiji; Takayasu, Misako

doi:10.1097/brs.0000000000000120

Cited by 29 publications

(22 citation statements)

References 11 publications

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“…Vertebral artery can be damaged in an anterior and lateral approach such as corpectomy or foraminotomy, as well as a posterior approach with screwing. [9] Right C7 transverse foramina were found in 77 (96.3%) female patients and 132 male (98.5%) patients, while the left C7 transverse foramina were found in 79 (98.8%) female patients and 132 male (98.5%) patients in our series. The right vertebral artery enters into the transverse foramen at C7 in 2 male patients (1.5%) and the left vertebral artery enters into the transverse foramen at C7 in six male patients (4.5%).…”

Section: Discussionmentioning

confidence: 43%

Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

Keskin

Erdi

Nayman

et al. 2015

J Craniovert Jun Spine

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Context:This study was designed to understand and define the special radio-anatomic morphometry of C7 vertebra by using multidetector computed tomography (MDCT).Aims:The major aim of the study was to detect the gender- and side-related morphometric differences of C7 vertebra among subjects.Setting and design:Our radiology unit database scanned for MDCT sections of the C7 vertebra.Materials and Methods:A total of 214 patients (134 men, 80 women) were selected. A detailed morphometric evaluation of C7 was done.Statistical analysis used:T test, ANOVA. Lamina length (P < 0.001), pedicle length (P < 0.001), outer cortical (P = 0.01) and inner cancellous pedicle (P < 0.001) width, pedicle angle to sagittal plane (P < 0.001) values were statistically significantly different on the right versus left side. When the results were stratified by gender, lamina length, inner cancellous lamina height, pedicle length, inner cancellous pedicle height, outer cortical pedicle width, lateral mass anteroposterior length, anteroposterior length of C7 corpus, height of C7 corpus (P < 0.001), C6-7 (P = 0.013) and C7-T1disc height (P = 0.04), transverse foramina perpendicular width at C7 (P = 0.046) values were found to be statistically significantly different. Vertebral artery most commonly enters into the transverse foramina at C6 level.Conclusions:Gender and side differences are important factors for preoperative planning and showed significant differences among subjects. MDCT is a practical option for investigating the exact anatomical features of osseous structures.

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Section: Discussionmentioning

confidence: 43%

Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

Keskin

Erdi

Nayman

et al. 2015

J Craniovert Jun Spine

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“…While some of these are because of surgical mishaps, others are the results of variations in arterial anatomy. 15,16 A medial loop of cervical arteries may pose a risk of injury during anterior surgical approach to the cervical spine. We, therefore, performed this study to investigate the prevalence and anatomical features of those anomalous arteries as well as related factors including degeneration, alignment of cervical spine, simultaneous vascular variations, and age were investigated in this study.…”

Section: Discussionmentioning

confidence: 99%

Risks for Vascular Injury During Anterior Cervical Spine Surgery

Wakao

Takeuchi

Nishimura

et al. 2016

SPINE

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“…In patients with VA anomalies such as fenestration, tortuous loops with/without bony erosion, and abnormal VA entries into the transverse foramen, [4][5][6][7] care must be taken to avoid iatrogenic VA injury during cervical spine surgery. In 90.0-95.6% of cases, the VA entered the transverse foramen of the cervical spine at the C6 level.…”

Section: Relationship Between Va Anomalies and The Va Location In Thementioning

confidence: 99%

“…4,7,14,15) Alternative entry sites were at C3 (0.2%), C4 (0.5-1.6%), C5 (3.1-5.0%), and C7 (0.3-0.8%). 4,6,7,15) The VA entry site may affect the treatment strategy in patients scheduled for cervical posterior surgery. In our series, 186 of 206 VAs (90.3%) entered the transverse foramen of the cervical spine at the C6 level.…”

Section: Relationship Between Va Anomalies and The Va Location In Thementioning

confidence: 99%

Is the Vertebral Posterior Line a Safety Landmark for Cervical Posterior Screw Insertion? – Radiological Study of the Vertebral Artery in the Cervical Spine

Kim

Nariai²,

Kawauchi³

et al. 2020

Neurol. Med. Chir.(Tokyo)

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At posterior cervical fixation, iatrogenic injury of the vertebral artery (VA) must be avoided. As the VA is usually located in front of the posterior line of the vertebral body, intraoperative lateral fluoroscopy is used to identify the line. We investigated in how many of 105 patients (210 VAs) this line is a safe marker. We also inspected the original cervical magnetic resonance angiograms (MRA) of 105 consecutive patients who had been treated for other than cervical spine diseases to study some anatomical characteristics of the VA in the cervical spine. The distance from the posterior line of the vertebral body to the posterior VA surface was classified as safe, as requiring attention, and as unsafe. Among the 210 VAs, four hypoplastic vessels were excluded from this study; consequently, 206 VAs were available for assessment. The average distance exceeded 6 mm, it was shorter at the upper cervical level. Although in at least 200 VAs (97.1%) the distance between C4 and C7 was safe, in only 170 VAs (82.5%) was it safe at C3. We observed a total of 31 tortuous loops in 17 VAs; their presence had a significant negative effect on the usefulness of the safety line. Although the posterior line of the vertebral body may be useful for safe screw insertion at the C4-C7 level, it may be less useful at C3. In the presence of tortuous VA loops, close attention must be paid to the reliability of the safety line during cervical spine surgery.

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Variance of Cervical Vertebral Artery Measured by CT Angiography and Its Influence on C7 Pedicle Anatomy

Abstract: 2.

Cited by 29 publications

References 11 publications

Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

Risks for Vascular Injury During Anterior Cervical Spine Surgery

Is the Vertebral Posterior Line a Safety Landmark for Cervical Posterior Screw Insertion? – Radiological Study of the Vertebral Artery in the Cervical Spine

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