Radiological and Surgical Anatomy of Ventral C1-C2 Complex

Area of Science:

• Anatomy
• Neurosurgery
• Surgical Anatomy

Background:

• The C1-C2 complex is critical for head stability and neurological function.
• Surgical approaches to the C1-C2 complex, such as odontoidectomy, require precise anatomical knowledge.
• Variations in C1-C2 bony structures can impact surgical outcomes.

Purpose of the Study:

• To evaluate detailed anatomical measurements of the bony structures within the C1-C2 complex.
• To provide essential data for planning transoral and transnasal surgical approaches to the C1-C2 complex.

Main Methods:

• Analysis of six formalin-fixed cadaveric head and neck specimens.
• Radiological imaging and precise anatomical measurements of C1-C2 complex bony landmarks.
• Measurements included C1-C2 distance, anterior tubercle-nares distance, anterior arch height, and odontoid articular surface dimensions.

Main Results:

• Mean C1 anterior tubercle-nares distance: 96.16 mm; superior incisors distance: 84.14 mm.
• Mean C1 anterior arch height: 13.89 mm; lateral mass distance: 19.10 mm.
• Odontoid base diameters: anteroposterior 12.12 mm, horizontal 11.12 mm; transoral/transnasal approach angles: ~32°.

Conclusions:

• Accurate anatomical data of ventral C1-C2 relationships are essential for safe odontoidectomy.
• Precise measurements of the odontoid, lateral mass, and midline are critical for surgical success.
• This study offers valuable anatomical insights for surgeons operating on the C1-C2 complex.