Vertebral artery variations at the C1–2 level diagnosed by magnetic resonance angiography

Uchino, Akira; Saito, Naoko; Watadani, Takeyuki; Okada, Yoshitaka; Kozawa, Eito; Nishi, Naoko; Mizukoshi, Waka; Inoue, Kentaro; Nakajima, Reiko; Takahashi, Masahiro

doi:10.1007/s00234-011-0849-z

Cited by 75 publications

(45 citation statements)

References 11 publications

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“…If the FIA persists along with the normal VA, it gives rise to fenestration or it may join the future PICA, making its origin anomalous. 7 Apart from these 3 variations we found a fourth; when the VA loops medially before entering the C-1 transverse foramen or the osseous canal (Fig. 6).…”

Section: Discussionmentioning

confidence: 79%

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Operative nuances to safeguard anomalous vertebral artery without compromising the surgery for congenital atlantoaxial dislocation: untying a tough knot between vessel and bone

Salunke¹,

Futane²,

Sahoo³

et al. 2014

SPI

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Section: Discussionmentioning

confidence: 79%

“…These variations have been described in 1% of the normal population but are quite often seen in those with congenital CVJ anomalies. 7,9 The VA develops from the plexiform anastomoses between 7 cervical intersegmental arter- Fig. 2.…”

Section: Discussionmentioning

confidence: 99%

Operative nuances to safeguard anomalous vertebral artery without compromising the surgery for congenital atlantoaxial dislocation: untying a tough knot between vessel and bone

Salunke¹,

Futane²,

Sahoo³

et al. 2014

SPI

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“…The C-1 LMS is a common method for C-1 fixation but it is technically demanding, especially when the lateral mass is obscured by a thick posterior arch, 39 ponticulus posticus, 17 anomalous VA, 17,28,35,37 or a large paravertebral venous plexus. 21 Goel et al reported 2 patients who required an alternative method and only 1-side LMS was completed in 9 cases.…”

Section: Discussionmentioning

confidence: 99%

“…7,21,39 If C1-2 was displaced after injury, the PS may exhibit stronger resistance. It was also shown that the incidence of a VA anomaly between C-1 and C-2 in Asia was more common than in the US, and it directly affected the safety of C-1 LMS placement, 17,28,35,37 so fixation must be planned to minimize the VA injury. The choice was also influenced by our clinical experience.…”

Section: 4mentioning

confidence: 99%

Unilateral C-1 posterior arch screws and C-2 laminar screws combined with a 1-side C1–2 pedicle screw system as salvage fixation for atlantoaxial instability

Jin

Wang

2016

SPI

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OBJECT Atlantoaxial instability often requires surgery, and the current methods for fixation pose some risk to vascular and neurological tissues. Thus, new effective and safer methods are needed for salvage operations. This study sought to assess unilateral C-1 posterior arch screws (PASs) and C-2 laminar screws (LSs) combined with 1-side C1–2 pedicle screws (PSs) for posterior C1–2 fixation using biomechanical testing with bilateral C1–2 PSs in a cadaveric model. METHODS Six fresh ligamentous human cervical spines were evaluated for their biomechanics. The cadaveric specimens were tested in their intact condition, stabilization after injury, and after injury at 1.5 Nm of pure moment in 6 directions. The 3 groups tested were bilateral C1–2 PSs (Group A); left side C1–2 PSs with an ipsilateral C-1 PAS + C-2 laminar screw (Group B); and left side C1–2 PSs with a contralateral C-1 PAS + C-2 LS (Group C). During the testing, angular motion was measured using a motion capture platform. Data were recorded, and statistical analyses were performed. RESULTS Biomechanical testing showed that there was no significant difference among the stabilities of these fixation systems in flexion-extension and rotation control. In left lateral bending, the bilateral C1–2 PS group decreased flexibility by 71.9% compared with the intact condition, the unilateral C1–2 PS and ipsilateral PAS+LS group decreased flexibility by 77.6%, and the unilateral C1–2 PS and contralateral PAS+LS group by 70.0%. Each method significantly decreased C1–2 movements in right lateral bending compared with the intact condition, and the bilateral C1–2 PS system was more stable than the C1–2 PS and contralateral PAS+LS system (p = 0.036). CONCLUSIONS A unilateral C-1 PAS + C-2 LS combined with 1-side C-1 PSs provided the same acute stability as the PS, and no statistically significant difference in acute stability was found between the 2 screw techniques. These methods may constitute an alternative method for posterior atlantoaxial fixation.

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“…Women are more likely to exhibit these anomalies (2). A persistent hypogloassl artery (PHA) is the second most common persistent fetal variant behind a persistent trigeminal artery with a prevalence of 0.02 -0.1% in the general population (3).…”

Section: Koleilat and Hanovermentioning

confidence: 99%

Carotid Endarterectomy in the Face of a Persistent Hypoglossal Artery

Koleilat

Hanover

2015

Annals of Vascular Surgery

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Vertebral artery variations at the C1–2 level diagnosed by magnetic resonance angiography

Cited by 75 publications

References 11 publications

Operative nuances to safeguard anomalous vertebral artery without compromising the surgery for congenital atlantoaxial dislocation: untying a tough knot between vessel and bone

Operative nuances to safeguard anomalous vertebral artery without compromising the surgery for congenital atlantoaxial dislocation: untying a tough knot between vessel and bone

Unilateral C-1 posterior arch screws and C-2 laminar screws combined with a 1-side C1–2 pedicle screw system as salvage fixation for atlantoaxial instability

Carotid Endarterectomy in the Face of a Persistent Hypoglossal Artery

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