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Does ponticulus posticus affect vertebral artery diameter.

Enes Gul1, Irfan Atik2

  • 1Department of Radiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey. enesguldr89@gmail.com.

Surgical and Radiologic Anatomy : SRA
|July 8, 2024
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Summary

Ponticulus posticus (PP) is an anomaly that can reduce vertebral artery diameter, potentially causing vertebrobasilar insufficiency. This study confirms PP

Keywords:
Cervical vertebraComputed tomographyMorphometryPonticulus posticusVertebral artery diameter

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Area of Science:

  • Radiology
  • Anatomy
  • Neurology

Background:

  • Ponticulus posticus (PP) is an ossification of the atlantooccipital ligament.
  • It is known to potentially compress the vertebral artery and first cervical nerve root.

Purpose of the Study:

  • To investigate the hypothesis that ponticulus posticus reduces vertebral artery diameter.
  • To determine the prevalence of PP and its association with vertebral artery dimensions.

Main Methods:

  • Retrospective review of 1365 cervical spine CT scans (January-December 2022).
  • Two expert radiologists evaluated images in 3D.
  • Vertebral artery diameter measured in patients with PP who underwent cervical angiography.

Main Results:

  • Ponticulus posticus (PP) was detected in 21.1% of patients (288/1365).
  • Vertebral artery diameters (right and left) were significantly smaller in patients with complete PP (p < 0.001).
  • Positive correlation observed between artery width/height and artery diameters in complete PP cases.

Conclusions:

  • Ponticulus posticus can lead to vertebrobasilar insufficiency by narrowing the vertebral artery.
  • Detailed imaging and evaluation of the atlantooccipital region are crucial for symptomatic patients.