Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
Department of Neurosurgery, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Surg Radiol Anat. 2021 Jun;43(6):929-941. doi: 10.1007/s00276-021-02712-x. Epub 2021 Mar 10.
The most common type of vascular complication during cervical spine surgery is the vertebral artery (VA) injury. The presence of anatomical variation in the artery's morphology has been a significant factor for arterial injury during surgery. Therefore, physicians planning interventions in the craniospinal region need to be aware of the extents of variations. In addition to vascular injury, anatomical variations can predispose to some pathologies in the posterior circulation territory. To provide useful data to interventional radiologists, anatomists, and surgeons, we evaluated the anatomical features of the V1 and V2 segments of the VA in a South African population.
The study is an observational, retrospective chart review of 554 consecutive South African patients (Black, Indian and White) who had undergone computed tomography angiography (CTA) from January 2009 to September 2019.
The VA exhibited morphological variation in its course. We report the incidence of variant origin of the left VA, all from the aortic arch. Variation in the level of entry into the transverse foramen ranged between C7 and C3. A left dominant pattern was observed; we also report on hypoplasia of the VA. In addition, we report incidence of VA tortuosity at V1, V2 to be 76.6% and 32.1%, respectively.
The baseline data established in this study regarding the diameter, variant origin, and level of entry into the transverse foramen will assist neurosurgeons and interventional radiologists in interpreting, diagnosing, and planning and executing various vascular procedures and treatment of pathology in the vicinity of the VA.
颈椎手术过程中最常见的血管并发症是椎动脉（VA）损伤。动脉形态的解剖变异一直是手术中动脉损伤的一个重要因素。因此，计划对颅脊柱区域进行干预的医生需要了解这些变异的程度。除了血管损伤外，解剖变异还可能导致后循环区域的一些病理变化。为了向介入放射科医生、解剖学家和外科医生提供有用的数据，我们评估了南非人群 VA 的 V1 和 V2 段的解剖特征。
该研究是对 2009 年 1 月至 2019 年 9 月连续 554 例南非患者（黑人、印度人和白人）进行计算机断层血管造影（CTA）的观察性、回顾性图表回顾。
VA 在其走行中表现出形态学变异。我们报告了左 VA 变异起源的发生率，均来自主动脉弓。进入横突孔的水平在 C7 至 C3 之间变化。观察到左优势模式；我们还报告了 VA 发育不良。此外，我们报告 VA 在 V1 和 V2 的迂曲发生率分别为 76.6%和 32.1%。
本研究中关于 VA 直径、变异起源和进入横突孔水平的基线数据将有助于神经外科医生和介入放射科医生解释、诊断以及规划和执行各种血管手术，并治疗 VA 附近的病理变化。
