Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Department of Anatomical Sciences, St. George's University, St. George's, Grenada.
World Neurosurg. 2020 May;137:304-309. doi: 10.1016/j.wneu.2020.01.231. Epub 2020 Feb 10.
Little attention has been given to the retroverted dens within the existing medical literature. However, this finding can have a clinical impact, especially in patients with Chiari malformation type I (CM1), as it can have consequences for further treatment.
Using standard search engines, we performed a literature review of anatomical, radiologic, and clinical studies as well as pathologic and surgical considerations related to the retroverted dens. Key words for our search included retroverted dens; retroflexed dens; odontoid retroflexion; posterior inclination; and tilted dens.
A retroverted dens is most commonly found in the pediatric population in relation to CM1. Research has demonstrated that high degree of dens angulation can result in significant anterior brain stem compression with the need for both anterior and posterior decompression in patients with symptomatic CM1.
A greater degree of dens angulation can lead to neurologic symptoms secondary to spinomedullary compression. Therefore, correct measurements are essential as such findings can influence presurgical planning.
现有医学文献中很少关注齿状突后倾。然而，这一发现可能具有临床意义，特别是在 Chiari 畸形 I 型（CM1）患者中，因为它可能对进一步的治疗产生影响。
我们使用标准搜索引擎，对与齿状突后倾相关的解剖学、影像学和临床研究以及病理学和手术考虑因素进行了文献回顾。我们搜索的关键词包括齿状突后倾、齿状突后屈、齿状突后旋、后倾和倾斜的齿状突。
齿状突后倾最常见于小儿与 CM1 相关。研究表明，齿状突角度较大可导致明显的前脑干压迫，对于有症状的 CM1 患者，需要前后减压。
齿状突角度较大可导致继发于脊髓压迫的神经症状。因此，正确的测量是必不可少的，因为这些发现会影响术前规划。
