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Related Experiment Videos

The ponticulus posticus: implications for screw insertion into the first cervical lateral mass.

Jason P Young1, Paul H Young, Michael J Ackermann

  • 1Department of Neurosurgery, St. Louis University School of Medicine, and Practical Anatomy Workshop, 3839 Lindell Boulevard, St. Louis, MO 63108, USA.

The Journal of Bone and Joint Surgery. American Volume
|November 3, 2005
PubMed
Summary

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The arcuate foramen, an atlas anomaly, occurs in 15.5% of patients. Recognizing this osseous variation on cervical radiographs is crucial for surgical safety, preventing vertebral artery injury during screw placement.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Anatomy

Background:

  • The arcuate foramen is an osseous anomaly of the first cervical vertebra (atlas).
  • This anomaly requires consideration during lateral mass screw placement in the atlas.
  • Failure to recognize it can lead to complications.

Purpose of the Study:

  • To determine the prevalence of the arcuate foramen in a patient population.
  • To highlight the clinical significance of this anomaly in surgical procedures.

Main Methods:

  • Retrospective review of 464 lateral cervical radiographs.
  • Anatomical identification of the arcuate foramen in cadavers.

Main Results:

  • The prevalence of the arcuate foramen was found to be 15.5% (72 instances in 464 radiographs).

Related Experiment Videos

  • Both complete and incomplete forms of the anomaly were observed.

    • Conclusions:

    • The arcuate foramen is a common but often unrecognized anomaly.
    • Preoperative identification on lateral radiographs is essential for surgeons.
    • Awareness prevents using the ponticulus posticus as a screw starting point, thus avoiding vertebral artery injury.