A novel approach to identifying C2 and C3 block vertebrae

Area of Science:

• Radiology
• Orthopedics
• Developmental Biology

Background:

• Congenital block vertebrae (BV) result from embryonic segmentation disorders, causing vertebral fusion.
• BV at the C2-C3 level is a common anomaly, crucial for accurate spinal labeling.
• Distinguishing BV from a long C2 vertebra can be diagnostically challenging.

Purpose of the Study:

• To propose and validate a novel method for recognizing congenital block vertebrae (BV) by measuring C2 vertebral height.
• To enhance the accuracy of differentiating BV from normal vertebrae, particularly in cases of suspected congenital anomalies.

Main Methods:

• A retrospective study compared C2 vertebral heights in 50 normal individuals and 30 patients with C2-C3 congenital fusion.
• Measurements were taken from T2-weighted midsagittal MRI images, specifically from the odontoid tip to the posteroinferior C2 border.
• Independent t-tests were used for statistical analysis of the height data.

Main Results:

• The mean C2 vertebral height was 33.22 mm in the normal group and 45.59 mm in the congenital fusion group.
• A statistically significant difference was observed between the two groups (p<0.05).
• A C2 vertebral height exceeding 33 mm was identified as atypical for normal individuals, serving as a diagnostic threshold.

Conclusions:

• Measuring C2 vertebral body height provides a novel and effective method for diagnosing congenital block vertebrae.
• This technique aids in accurate cervical spine numbering and enhances diagnostic precision, especially in patients with congenital anomalies.