Baena-Caldas Gloria P, Mier-García Juan F, Griswold Dylan P, Herrera-Rubio Adriana M, Peckham Ximara
Department of Pathology, SUNY Downstate Health Science University, Brooklyn, NY, United States.
Department of Morphology, Biomedical Sciences School, Division of Health Sciences, Universidad del Valle, Cali, Colombia.
Front Neurosci. 2024 Feb 28;18:1348066. doi: 10.3389/fnins.2024.1348066. eCollection 2024.
This study focuses on the atlas, a pivotal component of the craniovertebral junction, bridging the cranium and spinal column. Notably, variations in its arches are documented globally, necessitating a thorough assessment and categorization due to their significant implications in clinical, diagnostic, functional, and therapeutic contexts. The primary objective is to ascertain the frequency of these anatomical deviations in the atlas arches among a Colombian cohort using cone-beam computed tomography (CBCT).
Employing a descriptive, cross-sectional approach, this research scrutinizes the structural intricacies of the atlas arches in CBCT scans. Analytical parameters included sex distribution and the nature of anatomical deviations as per Currarino's classification. Statistical analyses were conducted to identify significant differences, including descriptive statistics and Chi-square tests. A systematic review of the literature was conducted in order to enhance the current Currarino's classification.
The study examined 839 CBCT images, with a nearly equal sex distribution (49.7% female, 50.3% male). Anatomical variations were identified in 26 instances (3%), displaying a higher incidence in females (X2 [(1, = 839) = 4.0933, = 0.0430]). The most prevalent variation was Type A (2.5%), followed by Type B (0.4%), and Type G (0.2%) without documenting any other variation. The systematic review yielded 7 studies. A novel classification system for these variations is proposed, considering global prevalence data in the cervical region.
The study highlights a statistically significant predominance of Type A variations in the female subset. Given the critical nature of the craniovertebral junction and supporting evidence, it recommends an amendment to Currarino's classification to better reflect these clinical observations. A thorough study of anatomical variations of the upper cervical spine is relevant as they can impact important functional aspects such as mobility as well as stability. Considering the intricate anatomy of this area and the pivotal function of the atlas, accurately categorizing the variations of its arches is crucial for clinical practice. This classification aids in diagnosis, surgical planning, preventing iatrogenic incidents, and designing rehabilitation strategies.
本研究聚焦于寰椎，它是颅颈交界区的关键组成部分，连接着头骨和脊柱。值得注意的是，寰椎弓的变异在全球范围内都有记录，鉴于其在临床、诊断、功能和治疗方面的重大影响，有必要进行全面评估和分类。主要目的是使用锥形束计算机断层扫描（CBCT）确定哥伦比亚队列中寰椎弓这些解剖学偏差的发生率。
本研究采用描述性横断面研究方法，仔细检查CBCT扫描中寰椎弓的结构复杂性。分析参数包括性别分布以及根据库里亚里诺分类法的解剖学偏差性质。进行了统计分析以确定显著差异，包括描述性统计和卡方检验。为了完善当前的库里亚里诺分类法，对文献进行了系统综述。
该研究检查了839张CBCT图像，性别分布几乎相等（女性占49.7%，男性占50.3%）。共发现26例（3%）解剖学变异，女性发生率更高（X2 [(1, = 839) = 4.0933, = 0.0430]）。最常见的变异类型是A型（2.5%），其次是B型（0.4%）和G型（0.2%），未记录到其他变异类型。系统综述得出7项研究。考虑到颈椎区域的全球患病率数据，提出了一种针对这些变异的新分类系统。
该研究突出了女性亚组中A型变异在统计学上的显著优势。鉴于颅颈交界区的关键性质及相关支持证据，建议对库里亚里诺分类法进行修订，以更好地反映这些临床观察结果。对上颈椎解剖学变异进行深入研究具有重要意义，因为它们可能会影响诸如活动度和稳定性等重要功能方面。考虑到该区域复杂的解剖结构以及寰椎的关键功能，准确分类其弓的变异对于临床实践至关重要。这种分类有助于诊断、手术规划、预防医源性事故以及设计康复策略。
