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Some upper cervical spine norms.

J Monu1, S P Bohrer, G Howard

  • 1Radiology Department, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.

Spine
|July 1, 1987
PubMed
Summary
This summary is machine-generated.

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Establishing norms for the upper cervical spine, this study found that predens angles and dens tilt are common in healthy adults. These findings indicate that certain variations do not necessarily signify ligamentous injury.

Area of Science:

  • Radiology
  • Orthopedics
  • Anatomy

Background:

  • Establishing normal anatomical variations in the upper cervical spine is crucial for accurate diagnosis.
  • Previous studies have lacked comprehensive data on specific measurements like the predens angle and dens tilt.

Purpose of the Study:

  • To define normal ranges and relationships for key upper cervical spine measurements in adults.
  • To determine if common variations (e.g., V-shaped predens space, tilted dens) are indicative of injury.

Main Methods:

  • Analysis of lateral cervical spine films from 175 normal adult examinations.
  • Measurement of predens angle in neutral and flexion positions.
  • Assessment of dens tilt angle and posterior arch of atlas position.

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Main Results:

  • Normal predens angle ranges: 0-13 degrees (mean 5.57) in neutral, 0-18 degrees (mean 9.27) in flexion.
  • Posterior dens tilt is common, ranging up to 35 degrees (mean 17.43).
  • V-shaped predens space and dens tilt do not reliably indicate cruciate ligament or other trauma.

Conclusions:

  • Common variations in predens angle and dens tilt are normal findings in asymptomatic adults.
  • Widening of the C1-C2 interspinous distance is not a reliable indicator of upper cervical spine ligamentous injury.