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Estimation of odontoid process posterior inclination, odontoid height, and pB-C2 line in the adult population.
J Neurosurg Spine. 2014 Feb; 20(2):172-7.JN

Abstract

OBJECT

Posterior odontoid process inclination has been associated with Chiari malformation Type I in the pediatric population. There are varying reports to support a reliable range of odontoid inclination angles in control adults. The purpose of this study is to estimate the normal measurements in adults for odontoid retroflexion, retroversion, height, and the pB-C2 line (a line drawn through the odontoid tip from the ventral dura perpendicular to a second line from drawn the basion to the inferoposterior aspect of C-2 vertebral body) to establish a normative reference in this population.

METHODS

After obtaining institutional review board approval, the authors performed a retrospective analysis of non-contrast enhanced cervical spine CT scans obtained in 150 consecutive control adults. Three neuroradiologists measured odontoid retroflexion, odontoid retroversion, odontoid height, and the pB-C2 line. The cohort was divided into sex and two age groups. Comparisons of the means with unpaired 2-tailed t-test were performed.

RESULTS

A total of 125 subjects met the inclusion criteria; 80 were men and 45 were women (mean age 52 years, range 18-89 years). The odontoid retroflexion angle ranged from 70° to 89° (mean 79.3° ± 4.9°), and the odontoid retroversion angle ranged from 57° to 87° (mean 71.9° ± 5.3°). The range and mean of odontoid height were 17-27 mm and 22 ± 1.8 mm, respectively. The mean pB-C2 line was 6.5 ± 2.1 mm with a range of 0-11.2 mm. The results were also compared with previously published pediatric data.

CONCLUSIONS

The current study demonstrates that the odontoid process in adults is anatomically different from that in children: it is longer, more posteriorly inclined, and has a greater pB-C2 line. Therefore, utilization of these parameters with previously published cutoffs in the pediatric population is not appropriate for surgical planning in adults.

Authors+Show Affiliations

Division of Neuroradiology, Department of Radiology, and.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24313675

Citation

Khaleel, Ziyad L., et al. "Estimation of Odontoid Process Posterior Inclination, Odontoid Height, and pB-C2 Line in the Adult Population." Journal of Neurosurgery. Spine, vol. 20, no. 2, 2014, pp. 172-7.
Khaleel ZL, Besachio DA, Bisson EF, et al. Estimation of odontoid process posterior inclination, odontoid height, and pB-C2 line in the adult population. J Neurosurg Spine. 2014;20(2):172-7.
Khaleel, Z. L., Besachio, D. A., Bisson, E. F., & Shah, L. M. (2014). Estimation of odontoid process posterior inclination, odontoid height, and pB-C2 line in the adult population. Journal of Neurosurgery. Spine, 20(2), 172-7. https://doi.org/10.3171/2013.10.SPINE13405
Khaleel ZL, et al. Estimation of Odontoid Process Posterior Inclination, Odontoid Height, and pB-C2 Line in the Adult Population. J Neurosurg Spine. 2014;20(2):172-7. PubMed PMID: 24313675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimation of odontoid process posterior inclination, odontoid height, and pB-C2 line in the adult population. AU - Khaleel,Ziyad L, AU - Besachio,David A, AU - Bisson,Erica F, AU - Shah,Lubdha M, Y1 - 2013/12/06/ PY - 2013/12/10/entrez PY - 2013/12/10/pubmed PY - 2014/4/9/medline SP - 172 EP - 7 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 20 IS - 2 N2 - OBJECT: Posterior odontoid process inclination has been associated with Chiari malformation Type I in the pediatric population. There are varying reports to support a reliable range of odontoid inclination angles in control adults. The purpose of this study is to estimate the normal measurements in adults for odontoid retroflexion, retroversion, height, and the pB-C2 line (a line drawn through the odontoid tip from the ventral dura perpendicular to a second line from drawn the basion to the inferoposterior aspect of C-2 vertebral body) to establish a normative reference in this population. METHODS: After obtaining institutional review board approval, the authors performed a retrospective analysis of non-contrast enhanced cervical spine CT scans obtained in 150 consecutive control adults. Three neuroradiologists measured odontoid retroflexion, odontoid retroversion, odontoid height, and the pB-C2 line. The cohort was divided into sex and two age groups. Comparisons of the means with unpaired 2-tailed t-test were performed. RESULTS: A total of 125 subjects met the inclusion criteria; 80 were men and 45 were women (mean age 52 years, range 18-89 years). The odontoid retroflexion angle ranged from 70° to 89° (mean 79.3° ± 4.9°), and the odontoid retroversion angle ranged from 57° to 87° (mean 71.9° ± 5.3°). The range and mean of odontoid height were 17-27 mm and 22 ± 1.8 mm, respectively. The mean pB-C2 line was 6.5 ± 2.1 mm with a range of 0-11.2 mm. The results were also compared with previously published pediatric data. CONCLUSIONS: The current study demonstrates that the odontoid process in adults is anatomically different from that in children: it is longer, more posteriorly inclined, and has a greater pB-C2 line. Therefore, utilization of these parameters with previously published cutoffs in the pediatric population is not appropriate for surgical planning in adults. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/24313675/Estimation_of_odontoid_process_posterior_inclination_odontoid_height_and_pB_C2_line_in_the_adult_population_ L2 - https://thejns.org/doi/10.3171/2013.10.SPINE13405 DB - PRIME DP - Unbound Medicine ER -