High riding vertebral artery

Rheumatoid arthritis RA might lead to atlantoaxial instability requiring transpedicular or transarticular fusion. High-riding vertebral artery HRVA puts patients at risk of injuring the vessel. However, high riding vertebral artery, to date, no relative risk RR has been calculated in order to quantitatively determine a true impact of RA as its risk factor.

Metrics details. This study aims to investigate the clinical application and feasibility of C2 subfacetal screws in patients with Klippel-Feil syndrome KFS , narrow C2 pedicles, and high-riding vertebral arteries HRVAs. The clinical data of seven patients with KFS, atlantoaxial dislocation, narrow C2 pedicles, and HRVAs treated with C2 subfacetal screws were analyzed in this retrospective study. The internal height, isthmus height, and pedicle width of C2 vertebra were measured using preoperative computed tomography CT. Subfacetal screws were inserted for 7 patients 12 sides. The position and length of the screws were observed using postoperative CT. Intraoperative dura mater and vertebral artery VA injuries were recorded.

High riding vertebral artery

Federal government websites often end in. The site is secure. The data that support the findings of this study are available from the corresponding author, TK, upon reasonable request. High-riding vertebral artery HRVA and narrow C2 pedicles C2P pose a great risk of injuring the vessel during C2 pedicle or transarticular screw placement. Recent meta-analysis revealed a paucity of European studies regarding measurements and prevalence of these anatomical variants. Three hundred eighty-three consecutive cervical spine CT scans with potential screw insertion sites were analyzed independently by two trained observers. Kappa statistics for inter- and intraobserver reliability as well as for inter-software agreement were calculated. Significant differences were found between females and males for all measurements. Each parameter showed either good or excellent inter- or intraobserver, and inter-software agreement coefficients. HRVA and narrow C2P are common findings in Central-European population and should be appreciated at the planning stage before craniocervical instrumentation.

Grade 0 indicates a normal facet joint, grade 1 shows joint space narrowing, grade 2 shows narrowing and sclerosis of facet joint, and grade 3 shows narrowing, sclerosis and osteophytes Fig, high riding vertebral artery. Case aberrant distal aortic arch origin with a retro-esophageal course Case aberrant distal aortic arch origin with a retro-esophageal course.

Metrics details. A high-riding vertebral artery HRVA is an intraosseous anomaly that narrows the trajectory for C2 pedicle screws. The prevalence of a HRVA is high in patients who need surgery at the craniovertebral junction, but reports about HRVAs in subaxial cervical spine disorders are limited. We sought to determine the prevalence of HRVAs among patients with subaxial cervical spine disorders to elucidate the potential risk for VA injury in subaxial cervical spine surgery. We included patients, 94 were with a main lesion from C3 to C7 subaxial group and were with a main lesion from T1 to L5 thoracolumbar group.

Its reported prevalence has varied widely. If overlooked during the approach for craniocervical fusion, injury to the vertebral arteries can occur, affecting the outcome. The present meta-analysis aimed to provide the pooled prevalence of HRVAs. Methods: A comprehensive database search was conducted by 3 of us. Peer-reviewed studies that had followed the strict definition for HRVAs and had reported its prevalence were included. The risk of bias was assessed using the anatomical quality assessment tool. The pooled prevalence was calculated using a random effects model. Results: The data from 20 studies with subjects sides were analyzed. The prevalence in those without the most important confounding factor, rheumatoid arthritis RA , was

High riding vertebral artery

Federal government websites often end in. The site is secure. To determine whether a thin-sliced pedicular-oriented computed tomography TPCT scan reconstructed from an existing conventional computed tomography CCT scan is more accurate for identifying vertebral artery groove VAG anomalies than CCT.

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Declarations Ethics approval For this kind of retrospective study no ethics approval was required. Option 3 Please enter at least 2 unique options. Springer, Verlag Wien, pp — Federal government websites often end in. The height of the isthmus is 2 mm. Tools Tools overview. The patency of the vertebral artery prior to the anterior surgery was noted on MRI. Moreover, the lack of the bony structure of the pedicle made it difficult to implant 3. V3 ascends from the curved transverse foramen of C2 axis and sweeps laterally over the transverse process. Second, the sample size of our study was relatively small. There were no sudden rises in blood pressure that may have predisposed the patient to arterial dissection. Rather, we believe that the change in alignment may have resulted in the dissection. Presently, commonly used alternatives to pedicle screws and transarticular screws include lamina screws, which are inserted through the junction of the spinous process and lamina.

High-riding vertebral artery HRVA and narrow C2 pedicles C2P pose a great risk of injuring the vessel during C2 pedicle or transarticular screw placement. Recent meta-analysis revealed a paucity of European studies regarding measurements and prevalence of these anatomical variants. Three hundred eighty-three consecutive cervical spine CT scans with potential screw insertion sites were analyzed independently by two trained observers.

All the authors gave final approval of the version to be published. Thus, both HRVA and narrow C2 pedicles should be looked for at the planning stage prior to craniocervical instrumentation in order to choose the safest treatment option. Third, examination images should be carefully studied before the procedure, with special focus on the internal height measurement and design of the screw path. The patient was maintained on dual antiplatelet therapy with aspirin and ticagrelor and brought back to the angiography suite 48 hours later for elective obliteration of the right vertebrovenous fistula. Vertebral artery. Anomalous vertebral arteries in the extra- and intraosseous regions of the craniovertebral junction visualized by 3-dimensional computed tomographic angiography: analysis of consecutive surgical cases and review of the literature. All four studies were of Asian origin. Next, de-duplication was conducted. Spine Phila Pa There is considerable redundancy of the artery between C2 and C1, which accommodates neck motion, and the artery runs in the sulcus arteriosus of the C1 posterior arch before penetrating the dura at the level of the foramen magnum. Abstract Objective: To examine the feasibility, safety, and efficacy of mobilization of the vertebral artery for C 2 pedicle screws in cases with high-riding vertebral artery HRVA.