Atlases with Arcuate Foramen Present Cortical Bone Thickening That May Contribute to Lower Fracture Risk

作者：Sanchis Gimeno Juan A^*; Llido Susanna; Guede David; Nalla Shahed; Martinez Soriano Francisco; Blanco Perez Esther; Caeiro Jose R

来源：World Neurosurgery, 2018, 117: E162-E166.

DOI：10.1016/j.wneu.2018.05.220

• Anatomic variants
• Anatomy
• Arcuate foramen
• Atlas
• Cadaver
• Cervical atlas
• Cervical spine
• Cortical bone
• Micro-computed tomography
• Risk factors
• Signs and symptoms
• Spine
• Vertebral artery

BACKGROUND: To date, no information about the cortical bone microstructural properties in atlas vertebrae with arcuate foramen has been reported. As a result, we aimed to test in an experimental model if there is a cortical bone thickening in an atlas vertebra which has an arcuate foramen that may play a protective role against bone fracture.
METHODS: We analyzed by means of micro-computed tomography the cortical bone thickness, the cortical volume, and the medullary volume (SkyScan 1172 Bruker micro-CT NV, Kontich, Belgium) in cadaveric dry atlas vertebrae with arcuate foramen and without arcuate foramen. We also reviewed a case series of 31 posterior atlas arch fractures to correlate the possible presence in the same atlas of both fracture and arcuate foramen.
RESULTS: The micro-computed tomography study revealed significant differences in cortical bone thickness (P < 0.001), cortical volume (P < 0.004), and medullary volume (P = 0.013) values between the arcuate foramen vertebrae and the nonarcuate foramen vertebrae. The clinical series found no coexistence in the same vertebra of a posterior atlas arch fractures and the arcuate foramen.
CONCLUSIONS: An atlas with arcuate foramen presents cortical bone thickening. This advantage in bone micro-architecture seems to contribute to a lower fracture risk compared to subjects without arcuate foramen as no coexistence in the same vertebra of a posterior atlas arch fractures and arcuate foramen was found.

• 出版日期2018-9