ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018
Variations of transverse foramina in cervical vertebrae: what happens to the vertebral artery?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 33 citations in OpenAlex.
- The prevalence of unclosed transverse foramina in the cervical spine of a South African population sample.Surgical and radiologic anatomy : SRA · 2026Article
- Endothelial senescence of the vertebral artery in the context of cervical degeneration: biomechanically driven remodeling of the hemodynamic environment.Frontiers in cell and developmental biology · 2026Review
- Percutaneous C1C2 transarticular screw fixation for atlantoaxial osteoarthritis with 3D navigation: technical note and functional outcomes.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Assessment of failure risks during C2 vertebra pedicle screw insertion using three-dimensional computed tomography angiography analysis: the role of high-riding vertebral artery and narrow pedicles.Surgical and radiologic anatomy : SRA · 2024Article
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- Morphology and morphometry of the transverse foramina of cervical vertebrae in an adult Kenyan population: a radiological study.African health sciences · 2024Article
- Management of complex vertebral artery anatomy in craniocervical surgery: A case report.Surgical neurology international · 2024Article
- Historic Horse Family Displaying Malformations of the Cervicothoracic Junction and Their Connection to Modern German Warmblood Horses.Animals : an open access journal from MDPI · 2023Article
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- Anatomical Variations of the Vertebral Artery: Analysis by Three-Dimensional Computed Tomography Angiography in Chinese Population.Orthopaedic surgery · 2021Observational
- Evaluation of tortuous vertebral arteries before cervical spine surgery: illustrative case.Journal of neurosurgery. Case lessons · 2021Article
- Review
- Traumatic vertebral artery injury: a review of the screening criteria, imaging spectrum, mimics, and pitfalls.Polish journal of radiology · 2019Review
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study is to examine variations of the foramen transversarium and the vertebral artery in computed tomography angiographies (CTa) of the cervical spine, investigate their coexistence, and present possible considerations regarding such variations in spine surgical procedures.
methodsFifty CTa of the neck were retrospectively reviewed. Transverse and anteroposterior diameter of the foramen and diameter of the vertebral artery were measured. Variations of the foramen and the vertebral artery were detected.
resultsCervical CTa of 32 males and 18 females (mean age 66.4 ± 10.78 years), all belonging to the Indo-European race, were reviewed. Variations of the foramen transversarium were found in 17 vertebrae (4.85%) of 15 patients (30%). Duplication of the foramen was the most frequent variation, followed by the open foramen, the absence of the foramen, the triple foramen, and the hypoplastic foramen. Variations of the vertebral artery were found in 7 patients (14%) and asymmetry was found in 12 (24%) patients. Moreover, six patients presented with hypoplastic vertebral arteries (12%). When examining coexistence, 60% of patients exhibiting variations in the transverse foramen were also exhibiting variations or asymmetry in the vertebral artery, compared to 25.7% of patients with no foramen variations (p = 0.02).
conclusionsVertebral artery injury is not common but may be a disastrous complication during cervical spine surgery. Proper preoperative planning is essential for any surgeon and exact knowledge of the anatomy in each patient is essential. This study strongly recommends the preoperative use of a CTa when suspicion of a variation is present and implied by a foramen variation. These slides can be retrieved under Electronic Supplementary Material.
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