IJAR.2016.479

Type of Article:  Original Research

Volume 5; Issue 1 (January 2017)

Page No.: 3367-3371

DOI: https://dx.doi.org/10.16965/ijar.2016.479

STUDY OF ARCUATE FORAMEN OF ATLAS VERTEBRAE

Santhi B 1, Dhanalakshmi V *2, Esther Yamuna N 3, Manoharan C 4.

1 Associate Professor, Govt. Medical College, Omanthurar Govt. Estate, Chennai, Tamilnadu, India.

*2 Associate Professor, Govt. Thoothukudi Medical College, Thoothukudi, Tamilnadu, India.

3 Assistant Professor, Govt. Thoothukudi Medical College, Thoothukudi, Tamilnadu, India.

4 Associate Professor, Govt. Tirunelveli Medical College, Tirunelveli, Tamilnadu, India.

Corresponding Author:  Dr.V.Dhanalakshmi.M.D. (Anatomy), Department of Anatomy, Government Thoothukudi Medical College, 3rd Mile, Thoothukudi – 628008, Tamilnadu, India. E-Mail: drlakshmidhana@gmail.com

ABSTRACT

Background: Variations in bone are common. Atlas vertebrae are especially subject to variation and are of clinical importance because of its close relation to vertebral artery. Bony spur can arise from the posterior margin for the groove of vertebral artery and form bridges known as ponticles. The bridges can be posterior, lateral or posterolateral. If the bridge is complete it is known as arcuate foramen. These variations can predispose to vertebrobasilar insufficiency.

Aim: To study the incidence of arcuate foramen and its various dimensions in the atlas vertebrae.

Materials and Methods: 58 human dry atlas vertebrae from Dept. of Anatomy, Govt. Thoothukudi Medical College, Tamilnadu were studied for the presence of arcuate foramen and ponticles and its dimensions were measured using digital vernier caliper.

Results: Arcuate foramen was found in 5 atlas vertebra (8.6%), one was bilateral and others were unilateral with equal incidence in right and left side. The mean length of the arcuate foramen was 6.09mm and the mean height of the arcuate foramen was 5.44mm. Ponticulus posterior was observed in 4 sides (3.45%) of atlas with higher incidence on left side (2.59%) and projection from superior articular facet posteriorly was found in 31.03% and also showed left side preponderance (17.24%). Exostosis from superior articular facet posterolaterally forming supratransverse foramen was observed in 4.31%.

Conclusion: Arcuate foramen can cause compression of vertebral artery during rotatory movements of neck and can result in vertebrobasilar insufficiency. It can also be a cause for vertigo. Having knowledge about this variation will be beneficial for the radiologist in interpreting and for neurosurgeons operating along the posterior arch.

KEY WORDS: Arcuate foramen, atlas, compression, ponticles, vertebrobasilar insufficiency.

REFERENCES

  1. Susan Standring. Grays Anatomy. 40th Churchill Livingstone. Spain. 2008:P-719
  2. Lalit M, Piplani S, Arora AK, Kullar JS, Sharma T. Incidence of Atlas Bridges and Tunnels–Their Phylogeny, Ontogeny and Clinical Implications. Revista Argentina de Anatomía Clínica. 2014;6(1):26-34.
  3. Hasan M, Shukla S, Siddiqui MS, Singh D. Posterolateral tunnels and ponticuli in human atlas vertebrae. Journal of anatomy. 2001 Sep 1;199(03):339-43.
  4. Bryce T.H. Quain’s Elements of Anatomy. Vol.IV Osteology and Arthrology. 11th Longmans, Green, and Co, New York. 1915: P-12- 14.
  5. Chummy S. Sinnatamby, Last’s Anatomy. 12th edition, 2011.p-426 churchill Livingstone.Edinburgh
  6. Krishnamurthy A, Nayak SR, Khan S, Prabhu LV, Ramanathan LA, Ganesh Kumar C, Prasad Sinha A. Arcuate foramen of atlas: incidence, phylogenetic and clinical significance. Rom J Morphol Embryol. 2007;48(3):263-6.
  7. Qudusia Sultana, Ramakrishna Avadhani, Varalakshmi KL, Shariff MH and Blessina. Variations of Foramen Transversarium in Atlas Vertebrae: A Morphological Study with its clinical significance. Nitte University Journal of Health Science.June 2015;5(2):80-83.
  8. Baeesa SS, Bokhari RF, Bajunaid KM, Al-Sayyad MJ. Prevalence of the foramen arcuale of the atlas in a Saudi population. Neurosciences (Riyadh). 2012 Oct 1;17:345-51.
  9. Sun JY. Foramen arcuale and vertigo. Zhonghua wai ke za zhi [Chinese journal of surgery]. 1990 Oct;28(10):592-4.
  10. Tubbs RS, Johnson PC, Shoja MM, Loukas M, Oakes WJ. Foramen arcuale: anatomical study and review of the literature. Journal of Neurosurgery: Spine. 2007 Jan;6(1):31-4.
  11. Li S, Li W, Sun J. Operative treatment for cervical vertigo caused by foramen arcuale. Zhonghua wai ke za zhi [Chinese journal of surgery]. 1995 Mar;33(3):137-9.
  12. Cakmak O, Gurdal E, Ekinci G, Yildiz E, Cavdar S. Arcuate foramen and its clinical significance. Saudi medical journal. 2005;26(9):1409-13.
  13. Koutsouraki E, Avdelidi E, Michmizos D, Kapsali SE, Costa V, Baloyannis S. Kimmerle’s anomaly as a possible causative factor of chronic tension-type headaches and neurosensory hearing loss: case report and literature review. International Journal of Neuroscience. 2010 Apr 1;120(3):236-9.
  14. Barsukov SF, Antonov GI. [Kimmerle’s anomaly and stroke]. Voenno-meditsinskii zhurnal. 1992 Oct;10:32-6.
  15. Lachkepiani AN, Kurdiukova-Akhvlediani LS. Circulatory disorders in the vertebrobasilar system in the presence of Kimmerle’s anomaly. Zh Nevropatol Psikhiatr Im S S Korsakova.1990;90(1):23-6.
  16. Cushing KE, Ramesh V, Gardner-Medwin D, Todd NV, Gholkar A, Baxter P, Griffiths PD. Tethering of the vertebral artery in the congenital arcuate foramen of the atlas vertebra: a possible cause of vertebral artery dissection in children. Developmental Medicine & Child Neurology. 2001 Jul 1;43(07):491-6.
  17. Krishnan P, Kartikueyan R, Patel SM, Das S. Ponticulus posticus: An anatomical curiosity with clinical implications. Neurology India. 2015 Sep 1; 63(5).
  18. Young JP, Young PH, Ackermann MJ, Anderson PA, Riew KD. The ponticulus posticus: implications for screw insertion into the first cervical lateral mass. J Bone Joint Surg Am. 2005 Nov1;87(11):2495-8.
  19. Cho YJ. Radiological analysis of ponticulus posticus in Koreans. Yonsei medical journal. 2009 Feb 28;50(1):45-9.
  20. Paraskevas G, Papaziogas B, Tsonidas C, Kapetanos G. Gross morphology of the bridges over the vertebral artery groove on the atlas.Surg Radiol Anat. 2005 Apr;27(2):129-36.

Cite this article: Santhi B, Dhanalakshmi V, Esther Yamuna N, Manoharan C. STUDY OF ARCUATE FORAMEN OF ATLAS VERTEBRAE. Int J Anat Res 2017;5(1):3367-3471. DOI: 10.16965/ijar.2016.479