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dc.contributor.authorEskander, Mark S.
dc.contributor.authorDrew, Jacob M.
dc.contributor.authorAubin, Michelle E.
dc.contributor.authorMarvin, Julianne
dc.contributor.authorFranklin, Patricia D
dc.contributor.authorEck, Jason C.
dc.contributor.authorPatel, Nihal
dc.contributor.authorBoyle, Katherine
dc.contributor.authorConnolly, Patrick J.
dc.date2022-08-11T08:10:09.000
dc.date.accessioned2022-08-23T16:57:08Z
dc.date.available2022-08-23T16:57:08Z
dc.date.issued2010-10-13
dc.date.submitted2010-12-13
dc.identifier.citationSpine (Phila Pa 1976). 2010 Nov 1;35(23):2035-40. <a href="http://dx.doi.org/10.1097/BRS.0b013e3181c9f3d4">Link to article on publisher's site</a>
dc.identifier.issn0362-2436 (Linking)
dc.identifier.doi10.1097/BRS.0b013e3181c9f3d4
dc.identifier.pmid20938397
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43076
dc.description.abstractSTUDY DESIGN: The aim of this study is to characterize the anatomy of vertebral arteries using magnetic resonance imaging scans of 250 consecutive patients. OBJECTIVES: To document the prevalence of midline vertebral artery (VA) migration in a subgroup of patients presenting with neck pain, radiculopathy, or myelopathy and to identify the course of the VA through the TFs. SUMMARY OF BACKGROUND DATA: Knowledge of VA anomalies and their respective prevalence may help surgeons decrease the incidence of iatrogenic injury to this artery. METHODS: In this retrospective review of 281 consecutive patients, who had an magnetic resonance imaging for axial neck pain, radiculopathy, or myelopathy, anatomic measurements were obtained from C2 to C7. RESULTS: The observed VA anomalies can be classified into following 3 main groups: (1) intraforaminal anomalies-midline migration, (2) extraforaminal anomalies, and (3) arterial anomalies. Midline migration of the VA was identified in 7.6% (19/250) of patients. The etiology can be degenerative or traumatic. It is important to note that the pattern of medial migration was clockwise rotation from caudal to cephalad and was present in all of our patients with anomalous arteries. Additionally, at C6, only 92% (460/500) of VAs were located within their respective transverse foramens and hypoplastic VAs were identified in 10% (25/250) of patients. CONCLUSION: Anomalies that must be considered before surgery include interforamenal anomalies, extraforamenal anomalies, and arterial anomalies. The intraforaminal anomalies involve midline migration, which places the VA at direct risk during corpectomy. Extraforaminal anomalies are related to VAs entering the transverse foramen at a level other than C6, which can increase the risk of injury during the anterior approach to the cervical spine. Arterial anomalies can be fenestrated, hypoplastic, or absent. These raise concern with the ability to maintain cerebral perfusion in the setting of damage to one of the VAs with the presence of contralateral arterial abnormality.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20938397&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1097/BRS.0b013e3181c9f3d4
dc.subjectVertebral Artery
dc.subjectMagnetic Resonance Imaging
dc.subjectCentral Nervous System Vascular Malformations
dc.subjectOrthopedics
dc.subjectRehabilitation and Therapy
dc.titleVertebral artery anatomy: a review of two hundred fifty magnetic resonance imaging scans
dc.typeJournal Article
dc.source.journaltitleSpine
dc.source.volume35
dc.source.issue23
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/9
dc.identifier.contextkey1694557
html.description.abstract<p>STUDY DESIGN: The aim of this study is to characterize the anatomy of vertebral arteries using magnetic resonance imaging scans of 250 consecutive patients.</p> <p>OBJECTIVES: To document the prevalence of midline vertebral artery (VA) migration in a subgroup of patients presenting with neck pain, radiculopathy, or myelopathy and to identify the course of the VA through the TFs.</p> <p>SUMMARY OF BACKGROUND DATA: Knowledge of VA anomalies and their respective prevalence may help surgeons decrease the incidence of iatrogenic injury to this artery. METHODS: In this retrospective review of 281 consecutive patients, who had an magnetic resonance imaging for axial neck pain, radiculopathy, or myelopathy, anatomic measurements were obtained from C2 to C7.</p> <p>RESULTS: The observed VA anomalies can be classified into following 3 main groups: (1) intraforaminal anomalies-midline migration, (2) extraforaminal anomalies, and (3) arterial anomalies. Midline migration of the VA was identified in 7.6% (19/250) of patients. The etiology can be degenerative or traumatic. It is important to note that the pattern of medial migration was clockwise rotation from caudal to cephalad and was present in all of our patients with anomalous arteries. Additionally, at C6, only 92% (460/500) of VAs were located within their respective transverse foramens and hypoplastic VAs were identified in 10% (25/250) of patients.</p> <p>CONCLUSION: Anomalies that must be considered before surgery include interforamenal anomalies, extraforamenal anomalies, and arterial anomalies. The intraforaminal anomalies involve midline migration, which places the VA at direct risk during corpectomy. Extraforaminal anomalies are related to VAs entering the transverse foramen at a level other than C6, which can increase the risk of injury during the anterior approach to the cervical spine. Arterial anomalies can be fenestrated, hypoplastic, or absent. These raise concern with the ability to maintain cerebral perfusion in the setting of damage to one of the VAs with the presence of contralateral arterial abnormality.</p>
dc.identifier.submissionpathortho_pp/9
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation
dc.source.pages2035-40


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