Basivertebral foramina of true vertebrae: morphometry, topography and clinical considerations

Basivertebral foramina (BVF) are openings of the posterior wall of vertebral body (VB) that lead to basivertebral canals (BVC), where homonymous neurovascular bundle courses. BVF and BVC are implicated with spinal fractures, vertebral augmentation and basivertebral nerve radiofrequency ablation. Despite their essential clinical impact, knowledge of BVF precise anatomy is scarce. The current study describes in detail the BVF typical morphological and topographical anatomy, morphometry and variants.

In total, 1561 dried true vertebrae of 70 Greek spines of known gender and age were examined. BVF number, location, shape and size (in foramina > 1 mm), BVF distance from VB rims and pedicles, as well as VB morphometry (diameters, heights and distance between pedicles) were studied. Ten spines were re-examined by computed tomography and BVC depth and shape were recorded. Correlations and differences were statistically analyzed.

C₁ lack BVF (3.4%). One BVF was found in 45.1%, two in 36.9%, three in 3.8% and four BVF in 0.6%. Multiple small (< 1 mm) foramina were observed in 10.1%. Asymmetry was detected in 12.3%. C₂ and T₁₀-L₁ presented typical pattern, whereas C₃ and T₂ had the greatest variability. BVF were significantly closer to the upper rim in C₂ and T₁₀-L₄ and to the lower rim in C₇-T₄, T₆-T₈ and L₅. The mean BVC depth was 12-21.8% of the VB anteroposterior diameter.

BVF number, shape, size and topography are described, in detail, per vertebral level. The provided morphological classification and the created cumulative BVF topographic graphs should assist in clinical practice and surgery.