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Variations in Entrance of Vertebral Artery in Korean Cervical Spine: MDCT-based Analysis
Hye Young Shin1, Ji Kang Park2, Sun Kyung Park3
1Department of Anesthesiology and Pain Medicine, Kosin University Gospel Hospital, Busan, Korea.
Insights
Anatomical variations in vertebral artery entry into cervical vertebrae are common. Pre-procedural imaging is crucial for safe interventional and surgical procedures involving the anterior cervical spine.
Area of Science:
- Anatomy
- Radiology
- Neurosurgery
Background:
- Knowledge of vertebral artery anatomical variation is critical for interventional and surgical procedure safety.
- Variations can impact the performance and safety of procedures involving the cervical spine.
Purpose of the Study:
- To investigate the anatomical variations of the vertebral artery's entrance into the cervical spine.
- To provide data on the prevalence of different vertebral artery entry points in a Korean population.
Main Methods:
- Analysis of 16-row multi-detector computed tomography (MDCT) images from 460 Korean patients.
- Observation of 920 vertebral arteries, focusing on the level of entrance into the transverse foramen.
- Assessment of vertebral artery origin sites and aberrant courses.
Main Results:
- The 6th cervical vertebra was the most common entry site (93.0%).
- Variations included entry into the 7th (0.2%), 5th (4.9%), and 4th (1.8%) cervical vertebrae.
- Specific percentages for right and left side entries at each level were documented.
Conclusions:
- Atypical courses of the vertebral artery (V1 and V2 segments) should be evaluated before anterior cervical procedures.
- Pre-procedural imaging, such as MRI or CT, is recommended to identify variations.
- This evaluation enhances patient safety during interventions near the anterior cervical vertebrae.
Background:
Knowledge of the anatomical variation of the vertebral artery has clinical importance not only for the performance of interventional or surgical procedures itself but also to ensure their safety. We conducted a study of the anatomical variation by reviewing multi-detector computed tomography (MDCT) images of the cervical spine from 460 Korean patients.
Methods:
16-row MDCT data from 460 patients were used in this study. We observed 920 vertebral arteries. Examination points included level of entrance of the artery into the transverse foramen of the cervical vertebra, origin site of the vertebral artery, course of a vertebral artery with aberrant entrance.
Result:
The vertebral artery in 2 (0.2%) cases in this study entered into the transverse foramen of the 7th cervical vertebra from the left. In 45 (4.9%) cases, the vertebral artery entered into the transverse foramen of the 5th cervical vertebra. Of these, the entrance was on the right in 15 (1.6%) and on the left in 30 (3.3%). We found 17 (1.8%) cases in which the artery entered into the transverse foramen of the 4th cervical vertebra, 10 (1.1%) on the right and 7 (0.7%) on the left side. As is commonly acknowledged, the 6th cervical vertebra was the most common site of entry; the vertebral artery entered the transverse foramen of the 6th cervical vertebra in the remaining 855 (93.0%) cases, on the right in 434 (47.2%) and on the left in 421 (45.8%).
Conclusions:
In conclusion, the possibility of an atypical course of the vertebral artery in segments V1 and V2 should be evaluated with magnetic resonance imaging (MRI) or CT images before carrying out procedures involving the anterior cervical vertebrae.
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