Anatomical Variations of the Foramen Transversarium in Cervical Vertebrae

Abstract

MOLINET, G. M.; ROBLES, F. P.; & ROA, I. Anatomical variations of the foramen transversarium in cervical vertebrae. Int. J. Morphol., 35(2):719-722, 2017. SUMMARY:The cervical vertebrae are recognized mainly by the presence of the foramen transversarium, which is crossed by the vertebral artery and vein, accompanied by sympathetic fibers. The main objective of this study was to observe and describe the anatomy and variations in the foramen transversarium. 121 cervical vertebrae were analyzed, including the macroscopic characteristics, shape and diameter and presence of the foramen transversarium, as well as the accessory foramen transversarium. All cervical vertebrae presented the foramen transversarium, with a mean diameter of 5.60 mm and a mean diameter of 4.40 mm on the right and 5.92 mm -5.56 mm on the left, respectively. With regard to shape classification according to Taitz et al. (1978), 90.08 % presented the same shape on both sides, and 9.91 % had different shapes. The presentation of the different shapes was as follows: shape 1 41.32 %; shape 2 4.13 %; shape 3 18.8 %; shape 4 14.04 %; and shape 5 12.39 %. Regarding the presence of accessory foramen transversarium, 17.35 % of the vertebrae presented it, 66.6 % unilateral, 57.14 % on the right side and 42.85 % on the left side. Osteophytes, were presented in 5.7 %. The anatomical knowledge of these variations is useful for spine surgeons in preoperative planning and for preventing vertebral vessel and sympathetic nerve injuries during cervical surgical approaches.

Morphometric Study and Anatomical Variation with its Incidence of Foramina Transversaria on the Lower Cervical Vertebrae

“…In our study, type 1 was the most common FT shape found at C3-C6, similar to previous results from South African (Abdul et al, 2018) as shown in Table VI. However, type 4 was most common at C7, which was comparable to findings in Japanese, Chinese, Indian (Kimura et al, 1985) Chilean (Guerra et al, 2017), and South African (Abdul et al, 2018) populations. By contrast, a study in an Israeli population by Taitz et al (1978) found only type 5 FT at C7.…”

“…FT variation is clinically significant to radiologists and surgeons planning posterior operations at the lower cervical spine (C3-C7). The morphometry (such as type and diameter) and rates of variance of FT have been found to differ by population, with previous studies being conducted in Israel, Japan, China, India, Italy, Turkey, the US, Greece, Spain, Chile, South Africa, and Korea (Taitz et al 1978;Kimura et al, 1985;Sangari et al, 2015;Zibis et al, 2016;Quiles-Guiñau et al, 2017;Guerra et al, 2017;Abdul et al, 2018;Malla et al, 2018;Gupta & Agarwal, 2019). Ours was the first study to report the incidence of variance and morphometric features of the lower cervical spine FT in a Thai population.…”

“…Classification of the foramina transversaria (FT).The types of FT belonging to lower cervical spines were classified into 5 types including the round (type 1), elliptical with anteroposterior (type 2), elliptical with transverse (type 3), elliptical with oblique from right to left (type 4), and elliptical with oblique from left to right side (type 5) as demonstrated in Figure 2 based on previous studies (Taitz et al, 1978;Zibis et al, 2016;Guerra et al, 2017;Abdul et al, 2018).…”

Estudo morfométrico do forame transverso

“…Comparando esse dado, estudos mostraram níveis altos de confiabilidade e reprodutibilidade das medidas por essa metodologia (CAGNIE et al, 2005;KIM et al, 2012;MOLINET GUERRA;ROBLES FUENTES;ROA, 2017;SUREKA et al, 2018;ZIBIS et al, 2018ZIBIS et al, , 2016.…”

“…melhor avaliação pré-operatória por meio da TC. Com relação à amostra, o número de indivíduos em nosso estudo não foi muito grande, mesmo sendo maior que o número de exames avaliados em estudos prévios(GUPTA et al, 2014;KAYA et al, 2011;MOLINET GUERRA;ROBLES FUENTES;ROA, 2017;TAITZ;NATHAN;ARENSBURG, 1978;ZIBIS et al, 2016). Entretanto, considerando a alta proporção de indivíduos detectados em nossa análise com variação anatômica no FT cervical, a avaliação pré-operatória dos parâmetros anatômicos do forame cervical deve ser considerada antes de realizar um procedimento cirúrgico que envolva a abordagem das vértebras cervicais.…”