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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2015; 25(02): 167-172
DOI: 10.4103/0971-3026.155868
Neuroradiology

Morphometric analysis of diameter and relationship of vertebral artery with respect to transverse foramen in Indian population

Binit Sureka
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Mahesh Kumar Mittal
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Aliza Mittal
Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Mukul Sinha Kanhaiya Agarwal
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Narendra Kumar Bhambri
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Brij Bhushan Thukral
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Correction to:

Morphometric analysis of diameter and relationship of vertebral artery with respect to transverse foramen in Indian population: ErratumIndian J Radiol Imaging 2015; 25(03): 328-328
DOI: 10.4103/0971-3026.161474

Abstract

Purpose: To study the location, origin, size and relationship of the vertebral artery and the transverse foramina in the lower cervical spine by computed tomographic angiography (CTA) measurements in the Indian population. Materials and Methods: A retrospective review of multi-detector CT (MDCT) cerebral angiography scans was done between June 2011 and February 2014. A total of 120 patients were evaluated. The diameter of the vertebral artery (AL) and the shortest distance between the vertebral artery and the medial (M), lateral (L), anterior (A), and posterior (P) borders of transverse foramen were studied. In addition, the shortest distance between the vertebral artery and pedicle (h) was also analyzed. Statistical Analysis: The means and their standard deviations (SD) were calculated in both the sexes. The t-tests were performed to look for significant sexual difference. Results: The largest vertebral artery diameter (AL) was at level C7 on the right side (3.5 ± 0.8) and at the level of C5 on the left side (3.7 ± 0.4). Statistically significant difference between males and females were seen at levels C4, C5, and C7. The diameter of the vertebral artery was smaller in females than males. The L value was greater than other parameters (M, A, P) at the same level in all the measurements. The h value was greatest at C6 level and shortest at C5. Conclusion: CTA is necessary before pedicle screw fixation due to variation in measurements at all levels. The highest potential risk of vertebral artery injury during cervical pedicle screw implantation may be at C5, then at C4, and the safest is at C7.

Keywords

Angiography - cervical spine - pedicle - vertebral artery


Publication History

Article published online:
30 July 2021

© 2015. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Greenspan A. Orthopedic Radiology: A Practical Approach. Philadelphia: Lippincott-Raven; 2000.
  • 2 Abumi K, Ito H, Taneichi H, Kaneda K. Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: Description of the techniques and preliminary report. J Spinal Disord 1994;7:19-28.
  • 3 Zhao L, Xu R, Hu T, Ma W, Xia H, Wang G. Quantitative evaluation of the location of thevertebral artery in relation to the transverse foramen in the lower cervical spine. Spine (Phila Pa 1976) 2008;33:373-8.
  • 4 Karaikovic EE, Kunakornsawat S, Daubs MD, Madsen TW, Gaines RW Jr. Surgical anatomy of the cervical pedicles: Landmarks for posterior cervical pedicle entrance localization. J Spinal Disord 2000;13:63-72.
  • 5 Wiesel SW. Pedicle screw fixation of the cervical spine [Internet]. Wolters Kluwer; Available from: st/chapter-sp-10/technique-pedicle-screw">https://www.inkling.com/read/operative-techniques-orthopaedic-surgery-vol-4-1st/chapter-sp-10/technique-pedicle-screw. [Last accessed on 2014 Mar 10].
  • 6 Cho KH, Shin YS, Yoon SH, Kim SH, Ahn YH, Cho KG. Poor surgical technique in cervical plating leading to vertebral artery injury and brain stem infarction--case report. Surg Neurol 2005;64:221-5.
  • 7 Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complication of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine (Phila Pa 1976) 2000;25:962-9.
  • 8 Yukawa Y, Kato F, Yoshihara H, Yanase M, Ito K. Cervical pedicle screw fixation in 100 cases of unstable cervical injuries: Pedicle axis views obtained using fluoroscopy. J Neurosurg Spine 2006;5:488-93.
  • 9 Yoshimoto H, Sato S, Hyakumachi T, Yanagibashi Y, Masuda T. Spinal reconstruction using a cervical pedicle screw system. Clin Orthop Relat Res 2005;111-9.
  • 10 Kast E, Mohr K, Richter HP, Börm W. Complications of transpedicular screw fixation in the cervical spine. Eur Spine J 2006;15:327-34.
  • 11 Neo M, Sakamoto T, Fujibayashi S, Nakamura T. The clinical risk of vertebral artery injury from cervical pedicle screws inserted in degenerative vertebrae. Spine (Phila Pa 1976) 2005;30:2800-5.
  • 12 Ludwig SC, Kowalski JM, Edwards CC 2 nd , Heller JG. Cervical pedicle screws: Comparative accuracy of two insertion techniques. Spine (Phila Pa 1976) 2000;25:2675-81.
  • 13 Patwardhan AR, Nemade PS, Bhosale SK, Srivastava SK. Computed tomography-based morphometric analysis of cervical pedicles in Indian population: A pilot study to assess feasibility of transpedicular screw fixation. J Postgrad Med 2012;58:119-22.