Ponticulus posticus: Morphometric analysis and Its anatomical Implications for occipito-cervical fusion
Myung Soo Song1, Ho Jin Lee1, Jong Tae Kim1
1Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, South Korea.
Clinical Neurology and Neurosurgery
|April 30, 2017
Summary
Ponticulus posticus (PP) anomalies offer anatomical advantages for posterior arch to lateral mass screw fixation (PALMSF) and occipital condyle fixation (OCF) surgeries. However, gender-specific anatomical variations necessitate cautious surgical approaches in females.
Area of Science:
- Neurosurgery
- Anatomy
- Medical Imaging
Background:
- Ponticulus posticus (PP) is a bony anomaly in the upper cervical spine.
- Its impact on high cervical fixation surgeries is not fully understood.
Purpose of the Study:
- To evaluate the morphometric characteristics of ponticulus posticus (PP).
- To determine the impact of PP on posterior arch to lateral mass screw fixation (PALMSF) and occipital condyle fixation (OCF).
Main Methods:
- Retrospective analysis of 2628 head and neck 3D-CT angiographies.
- Measurement of vertebral artery groove height (VAGH), arch to vertebral artery distance (AVD), posterior arch height (PAH), and vertebral artery to occipital bone distance (VOD).
Main Results:
- PP identified in 7.1% of patients, more common in males and on the left.
- PP did not negatively impact the feasibility of safe PALMSF.
- PP anomaly side showed significantly higher VOD, increasing OCF safety margins.
Conclusions:
- PP anomalies may provide anatomical advantages for PALMSF and OCF.
- Gender-specific anatomical differences (VAGH, VOD, AVD) require cautious surgical planning in female patients.
Related Concept Videos
01:14Cranial Bones: Superior and Posterior View
8.3K
The superior view of the cranium shows the frontal and paired parietal bones.
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
8.3K
01:22Sutures of the Skull
13.7K
The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
13.7K
01:27Cranial Bones: Lateral View
7.6K
The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
7.6K
01:28Articulations of the Vertebral Column
3.4K
In addition to being held together by the intervertebral discs, adjacent vertebrae also articulate with each other at synovial joints formed between the superior and inferior articular processes called zygapophysial joints (facet joints). These are plane joints that provide for only limited motions between the vertebrae. The orientation of the articular processes at these joints varies in different regions of the vertebral column and serves to determine the types of motions available in each...
3.4K
01:08Overview of the Skull
8.4K
The cranium (skull) is the skeletal structure of the head that supports the face and protects the brain. It is subdivided into the facial bones and the brain case, or cranial vault. The facial bones underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws.
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...
8.4K
01:19Muscles that Move the Head
6.4K
The muscles that move the head are a dynamic and complex group of structures that work together to facilitate a wide range of head movements, including rotation, flexion, extension, and lateral bending.
The bilateral sternocleidomastoid, or SCM, and the suprahyoid and infrahyoid muscles are significant head flexors. The SCM muscles originate at the sternum and clavicle and attach to the mastoid process of the temporal bone. The SCM contracts bilaterally to bend the head forward, whereas...
The bilateral sternocleidomastoid, or SCM, and the suprahyoid and infrahyoid muscles are significant head flexors. The SCM muscles originate at the sternum and clavicle and attach to the mastoid process of the temporal bone. The SCM contracts bilaterally to bend the head forward, whereas...
6.4K