Morphometric Study of Axis Vertebra in Subjects of Indian Origin


Affiliations

  • Punjab Institute of Medical Sciences, Department of Anatomy, Jalandhar, Punjab, India
  • DMCH, Department of Anatomy, Ludhiana, India

Abstract

Background: The axis vertebra, exhibits complex and extensive variability in the morphology and there are vital neurovascular structures in its proximity. Knowledge of this variability is important for neurosurgeons, orthopaedicians, otorhynologists and other physicians who in everyday practice are in contact with disorders of the spine and their consequences.

Objective: The aim was to evaluate various morphometric dimensions of axis vertebrae and to compare with the available data.

Material and Methods: 50 dried human axis vertebrae of Indian origin, available in the Department of Anatomy, Dayanand Medical College and Hospital, Ludhiana were studied. Various dimensions were taken with vernier calipers, metric scale and graph paper. The dimensions were measured in millimetres and statistically analysed with paired t-test.

Results: The mean of maximum anteroposterior diameter (max.APD) and maximum transverse diameter (max.TD) of Superior Articular Facet (SAF) was measured as 17.42mm±1.73 and 15.31mm±1.44 on the right side, 17.64mm±1.51 and 15.17mm±1.48 on left side. The mean Distance from Lateral most edge of SAF to Midline was measured as 22.56mm ± 2.37 and 22.40mm ± 2.16 on the right and left sides, respectively. The mean Distance from Tip of Transverse Process to Midline was 26.45mm ± 2.85 on the right and 26.03mm ± 2.64 on the left side. The mean Height of Dens was measured as 13.83mm ± 1.52, mean Width of Dens as 9.57mm ± 0.85. Width of Pedicle was measured as 10.52mm ± 1.99 and 10.61mm ± 1.67on right and left sides, respectively.

Conclusion: The knowledge of these dimensions can provide useful information for safe planning of osseous fixation.


Keywords

Axis, Dens, Pedicle, Articular Facet, Vertebra.

Subject Discipline

Orthopaedics

Full Text:

References

Johnston M, Ranieri S, de Wit W. Proposal of a new method of treating type II odontoid fractures: Odontoid process prosthetic (Ti). Studies by Undergraduate Researchers at Guelph 2008;1(2):49-56.

Pait TG, Arnautovic KI, Borba LA. The anatomy of atlantoaxial complex. Perspect Neurol Surg 1997;7:91-8.

Abumi K, Kaneda K. Pedicle screw fixation for nontraumatic lesions of the cervical spine. Spine 1997;22(16):1853-63.

Richter M, Amiot LP, Neller S, Kluger P, Puhl W. Computer-assisted surgery in posterior instrumentation of the cervical spine: an invitro feasibility study. Eur Spine J 2000;9(1):65-70.

Reddy C, Ingalhalikar AV, Channon S, Lim T, Torner J, Hitchon PW. In vitro biomechanical comparison of transpedicular versus translaminar C-2 screw fixation in C2-3 instrumentation. J Neurosurg Spine 2007oct; 414-8.

Sengul G, Kadioglu HH. Morphometric anatomy of the atlas and axis vertebrae. Turk Neurosurg 2006;16(2):69-76.

York JE, Klimo P, Apfelbaum RI. Treatment of Axis Fractures. In: Winn HR, Dacey Jr RJ, Sonntag VK, Vollmer DG, editors. Youmans Neurological Surgery. 5th ed. Philadelphia: Saunders; 2004.p.4939-49.

Shetty A, Kini AR, Prabhu J. Odontoid fractures: a retrospective analysis of 53 cases. IJO 2009;43(4):352-60.

Bellabarba C, Mirza SK, Chapman JR. Injuries of the Craniocervical Junction. In: Bucholz RW, Heckman JD, Court-Brown CM, editors. Rockwood and Green’s Fractures in Adults. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006.p.1435-96.

Wood II GW. Fractures, Dislocations and Fracture-Dislocation of the Spine. In: Canal ST, Beaty JH, editors. Campbell’s Operative Orthopedics. 11th ed. Philadelphia: Mosby Elsevier; 2008.p.1761-850.

Chittiboina P, Wylen E, Ogden A, Mukherjee DP, Vannemreddy P, Nanda A. Traumatic spondylolisthesis of the axis: a biomechanical comparison of clinically relevant anterior and posterior fusion techniques. J Neurosurg Spine 2009;11:379-87.

Sorrenti L, Iamaguchi MM, Sposeto RB, Araujo MP, Iutaka AS, Filho TE, et al. Posterior instrumentation for laminar screw of C2: a dimensional anatomic study of axis. Acta Orthop Bras 2009;17(4):219-23.

Vilela MD, Jermani C, Braga BP. C1 lateral mass screws for posterior segmental stablization of the upper cervical spine and a new method of three-point rigid fixation of the C1-C2 complex. Arq Neuropsiquiatr 2006;64(3-B):762-7.

Wright NM, Lauryssen C. Vertebral artery injury in C1-2 transarticular screw fixation: results in a survey of the AANS/CNS section on disorders of the spine and peripheral nerves. J Neurosurg Spine 1998 april;88:63440.

Lundy DW, Murray HH. Neurological deterioration after posterior wiring of the cervical spine. The Journal of Bone And Joint Surgery. 1997;79B(6):948-51.

Miyamoto H, Uno K. Cervical pedicle screw insertion using a computed tomography cutout technique. J Neurosurg Spine 2009 dec;11:681-7. Neurological Surgery. 5th ed. Philadelphia: Saunders; 2004.p.4939-49.

Konig SA, Goldammer A, Vitzthum HE. Anatomical data on the craniocervical junction and their correlation with degenerative changes in 30 cadaveric specimens. J Neurosurg Spine 2005 nov;3:379-85.

Cattrysse E, Provyn S, Gagey O, Kool P, Clarys JP, Roy PV. In vitro three dimensional morphometry of the lateral atlantoaxial articular surfaces. Spine 2008;33(14):1503-8.

Kandziora F, Schulze-Stahl N, KhodadadyanKlostermann C, Schroder R, Mittlmeier T. Screw placement in transoral atlantoaxial plate systems: an anatomical study. J Neurosurg (Spine1) 2001july;95:80-7.

Gomez-Olivencia A, Carretero JM, Arsuaga JL, Rodriguez-Garcia L, Garcia-Gonzalez R, Martinez I. Metric and morphological study of the upper cervical spine from Sima de los Huesos site(Sierra de Atapuerca, Burgos, Spain. J Hum Evol 2007;53:6-25.

Mazzara JT, Feilding JW. Effect of C1-C2 rotation on canal size. Clin Orthop Relat Res 1988;237:115-9.

Doherty BJ, Heggeness MH. Quantitative anatomy of the second cervical vertebra. Spine 1995;20(5):513-7.

Jasinski R, Pezowicz C. Experimental investigation of the axis dens fracture. Acta Bioeng Biomech 2004;6(1):51-61.

Madawi AA, Casey AT, Solanki GA, Tuite G, Veres R, Crockard HA. Radiological and anatomical evaluation of the atlantoaxial transarticular screw fixation technique. J Neurosurg 1997 june;86:961-8.

Solanki GA, Crockard HA. Preoperative determination of safe superior transarticular screw trajectory through the lateral mass. Spine 1999;24(14):1477-82.

Mandel IM, Kambach BJ, Petersilge CA, Johnstone B, Yoo JU. Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws. Spine 2000;25(12):1542-7.

Bloch O, Holly LT, Park J, Obasi C, Kim K, Johnson JP. Effect of frameless stereotaxy on the accuracy of C1-2 transarticular screw placement. J Neurosurg Spine 2001july;95:749.

Gupta S, Goel A. Quantitative anatomy of the lateral masses of the atlas and axis vertebrae. Neurol India 2000 june;48:120-5.

Cacciola F, Phalke U, Goel A. Vertebral artery in relationship to C1-C2 vertebrae: An anatomical study. Neurol India 2004 june;52(2):178-84.

Kazan S, Yildrim F, Sindel M, Tuncer R. Anatomical evaluation of the groove for the vertebral artery in the axis vertebrae for atlanto-axial transarticular screw fixation technique. Clin Anat 2000;13:237-43.

Hoh DJ, Liu CY, Wang MY. A radiographic computed tomography- base study to determine the ideal entry point, trajectory, and length for safe fixation using C-2 pars interarticularis screws. J Neurosurg Spine 2010 june;12:602-12.


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