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Study of Ponticulus Posticus in Dry Atlas Vertebrae in Central Gujarat Region and its Clinical Significance |
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Kintukumar Vyas, HG Joshi, Shital Patel, Bhavesh Shroff 1. Assistant Professor, Department of Anatomy, Medical College, Vadodara, Gujarat, India. 2. Tutor, Department of Anatomy, Government Medical College, Bhavnagar, Gujarat, India. 3. Tutor, Department of Anatomy, Medical College, Vadodara, Gujarat, India. 4. Assistant Professor, Department of Preventive and Social Medicine, Medical College, Vadodara, Gujarat, India. |
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Correspondence Address : Dr. Hemang Girishchandra Joshi, 28, Monali Park, Opp. Old More Mega Store, Manjalpur, Vadodara-390011, Gujarat, India. E-mail: joshihemang30@yahoo.com |
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| ABSTRACT |  | ||||||||||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||||||||||
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| Keywords : Headache, Vertebral artery, Vertebrobasilar insufficiency | |||||||||||||||||||||||||
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| INTRODUCTION |
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The first cervical vertebra which supports the head also known as atlas vertebrae has two lateral masses united by an anterior and a posterior arch. There is a wide groove for the vertebral artery on the superior surface of the posterior arch. Occasionally, the bony projections arise from the anterior and posterior margins of the groove and convert the groove into a foramen which may put the vertebral artery at risk during injury or surgical procedures around the atlas vertebrae. Such bony projections are known as ponticles (1). The foramen thus formed is known as ponticulus posticus means posterior bridge. In the event of presence of posterior or lateral vertebral artery foramen be it complete or incomplete or be unilateral or bilateral, the vertebral artery becomes unsafe and is liable Keywords: Headache, Vertebral artery, Vertebrobasilar insufficiency to be pressed on (2) (Table/Fig 1). This pressure causes vertebrobasilar insufficiency and produce symptoms like vertigo, dizziness, nausea, headache etc. Other words used for this foramen are arcuate foramen or Kimmerly’s anomaly etc., (3). With this information in mind, the present study was taken up to find out the occurrence rate of ponticulus posticus in atlas vertebra with its measurements so as to correlate with its clinical significance. | |||||||||||||||||||||||||
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| TABLES AND FIGURES |
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Original article / research
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