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Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients.
Neurosurg Focus. 2015 Apr; 38(4):E5.NF

Abstract

OBJECT

Most of the craniometric relationships of the normal craniocervical junction (CCJ), especially those related to angular craniometry, are still poorly studied and based on measurements taken from simple plain radiographs. In this study, the authors performed a craniometric evaluation of the CCJ in a population without known CCJ anomalies. The purpose of the study was to evaluate the normal CCJ craniometry based on measurements obtained from CT scans.

METHOD

The authors analyzed 100 consecutive CCJ CT scans obtained in adult patients who were admitted at their tertiary hospital for treatment of non-CCJ conditions between 2010 and 2012. A total of 17 craniometrical measurements were performed, including the relation of the odontoid with the cranial base, the atlantodental interval (ADI), the clivus length, the clivus-canal angle (CCA)-the angle formed by the clivus and the upper cervical spine, and the basal angle.

RESULTS

The mean age of the 100 patients was 50.6 years, and the group included 52 men (52%) and 48 women (48%). In 5 patients (5%), the tip of the odontoid process was more than 2 mm above the Chamberlain line, and in one of these 5 patients (1% of the study group). it was more than 5 mm above it. One patient had a Grabb-Oakes measurement above 9 mm (suggesting ventral cervicomedullary encroachment). The mean ADI value was 1.1 mm. The thickness of the external occipital protuberance ranged from 7.42 to 22.36 mm. The mean clivus length was 44.74 mm, the mean CCA was 153.68° (range 132.32°-173.95°), and the mean basal angle was 113.73° (ranging from 97.06°-133.26°).

CONCLUSIONS

The data obtained in this study can be useful for evaluating anomalies of the CCJ in comparison with normal parameters, potentially improving the diagnostic criteria of these anomalies. When evaluating CCJ malformations, one should take into account the normal ranges based on CT scans, with more precise bone landmarks, instead of those obtained from simple plain radiographs.

Authors+Show Affiliations

Department of Neurology, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25828499

Citation

Batista, Ulysses C., et al. "Computed Tomography Evaluation of the Normal Craniocervical Junction Craniometry in 100 Asymptomatic Patients." Neurosurgical Focus, vol. 38, no. 4, 2015, pp. E5.
Batista UC, Joaquim AF, Fernandes YB, et al. Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients. Neurosurg Focus. 2015;38(4):E5.
Batista, U. C., Joaquim, A. F., Fernandes, Y. B., Mathias, R. N., Ghizoni, E., & Tedeschi, H. (2015). Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients. Neurosurgical Focus, 38(4), E5. https://doi.org/10.3171/2015.1.FOCUS14642
Batista UC, et al. Computed Tomography Evaluation of the Normal Craniocervical Junction Craniometry in 100 Asymptomatic Patients. Neurosurg Focus. 2015;38(4):E5. PubMed PMID: 25828499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients. AU - Batista,Ulysses C, AU - Joaquim,Andrei F, AU - Fernandes,Yvens B, AU - Mathias,Roger N, AU - Ghizoni,Enrico, AU - Tedeschi,Helder, PY - 2015/4/2/entrez PY - 2015/4/2/pubmed PY - 2015/12/17/medline KW - ADI = atlantodental interval KW - CCA = clivus-canal angle (angle formed by a line extending from the surface of the clivus and a line extending from the inferodorsal portion of the C-2 body) KW - CCJ = cranicervical junction KW - CM = Chiari malformation KW - CT scan KW - EOP = external occipital protuberance KW - FM = foramen magnum KW - craniocervical junction KW - craniometry KW - normal KW - relationship SP - E5 EP - E5 JF - Neurosurgical focus JO - Neurosurg Focus VL - 38 IS - 4 N2 - OBJECT: Most of the craniometric relationships of the normal craniocervical junction (CCJ), especially those related to angular craniometry, are still poorly studied and based on measurements taken from simple plain radiographs. In this study, the authors performed a craniometric evaluation of the CCJ in a population without known CCJ anomalies. The purpose of the study was to evaluate the normal CCJ craniometry based on measurements obtained from CT scans. METHOD: The authors analyzed 100 consecutive CCJ CT scans obtained in adult patients who were admitted at their tertiary hospital for treatment of non-CCJ conditions between 2010 and 2012. A total of 17 craniometrical measurements were performed, including the relation of the odontoid with the cranial base, the atlantodental interval (ADI), the clivus length, the clivus-canal angle (CCA)-the angle formed by the clivus and the upper cervical spine, and the basal angle. RESULTS: The mean age of the 100 patients was 50.6 years, and the group included 52 men (52%) and 48 women (48%). In 5 patients (5%), the tip of the odontoid process was more than 2 mm above the Chamberlain line, and in one of these 5 patients (1% of the study group). it was more than 5 mm above it. One patient had a Grabb-Oakes measurement above 9 mm (suggesting ventral cervicomedullary encroachment). The mean ADI value was 1.1 mm. The thickness of the external occipital protuberance ranged from 7.42 to 22.36 mm. The mean clivus length was 44.74 mm, the mean CCA was 153.68° (range 132.32°-173.95°), and the mean basal angle was 113.73° (ranging from 97.06°-133.26°). CONCLUSIONS: The data obtained in this study can be useful for evaluating anomalies of the CCJ in comparison with normal parameters, potentially improving the diagnostic criteria of these anomalies. When evaluating CCJ malformations, one should take into account the normal ranges based on CT scans, with more precise bone landmarks, instead of those obtained from simple plain radiographs. SN - 1092-0684 UR - https://www.unboundmedicine.com/medline/citation/25828499/Computed_tomography_evaluation_of_the_normal_craniocervical_junction_craniometry_in_100_asymptomatic_patients_ L2 - https://thejns.org/doi/10.3171/2015.1.FOCUS14642 DB - PRIME DP - Unbound Medicine ER -