Travan Luciana, Saccheri Paola, Sabbadini Gastone, Crivellato Enrico
Department of Medical and Morphological Research, Section of Anatomy, University of Udine Medical School, Piazzale Kolbe 3, 33100 Udine, Italy.
Surg Radiol Anat. 2011 Aug;33(6):495-500. doi: 10.1007/s00276-010-0760-z. Epub 2010 Dec 14.
We observed a complex atlas (C1) dysmorphism in a human medieval skeleton dug up from the sixth to the seventh century necropolis located in the north-eastern Italy. We analyzed such a dysmorphism in the light of pertinent literature and discussed the functional and clinical implications related to this type of C1 structural malformation.
Macroscopical and CT-SCAN examinations of the atlas were carried out.
Bone findings consisted of partial aplasia of the posterior arch of the C1 accompanied by a bilateral arcuate foramen. In addition, the spinous processes of C7 and T1 were found to be bifid.
Although such abnormalities are supposed to be clinically inconspicuous, yet they may become challenging or even dangerous in the context of trauma. They may even complicate specific diagnostic or surgical procedures. In addition, they may cause a great number of symptoms, ranging from headache and neck pain to loss of postural muscle tone and consciousness, due to the close and complex relationship of bone structures with nerves, blood vessels, muscles, and ligaments. As a result, radiologists, clinicians, surgeons, and chiropractors should consider in their clinical reasoning the possibility that atlas dysmorphisms may occur.
我们在从意大利东北部一座建于6至7世纪的墓地挖掘出的一具中世纪人类骨骼中观察到寰椎（C1）畸形。我们根据相关文献分析了这种畸形，并讨论了与这种C1结构畸形相关的功能和临床意义。
对寰椎进行了宏观和CT扫描检查。
骨骼检查结果显示C1后弓部分发育不全，并伴有双侧弓形孔。此外，还发现C7和T1的棘突呈双叉状。
尽管这些异常在临床上可能不明显，但在创伤情况下可能会变得具有挑战性甚至危险。它们甚至可能使特定的诊断或外科手术复杂化。此外，由于骨骼结构与神经、血管、肌肉和韧带之间密切而复杂的关系，它们可能导致大量症状，从头痛和颈部疼痛到姿势性肌张力丧失和意识丧失。因此，放射科医生、临床医生、外科医生和脊椎按摩师在临床推理中应考虑到寰椎畸形可能发生的可能性。
