Morphological status of assimilated atlas vertebra with occipital bone and its clinical significance
Keywords:
Atlas, Transverse process, Atlanto-occipitalAbstract
Background: Atlas is the first cervical vertebra. Sometimes there is partial or complete fusion of atlas with basal part of the occipital bone known as assimilation of atlas or atlanto-occipital fusion. It is normally congenital. It may be associated with the constriction of foramen magnum which may compress the spinal cord or brain stem.
Methods: The 1000 human dry skulls were selected from the anthropology museum of department of anatomy, GSVM medical college, Kanpur. The age and sex of the skulls were not taken into consideration. The skulls were examined for the bony union between the atlas and skull and other variations in assimilated atlas.
Results: Fused atlas with skull was seen in 20 skulls (2.0%). Partial fusion of anterior arch of atlas with the occipital bone was seen in 1 specimen (5%) and in 10% it was found complete fusion. In 10% skulls the posterior arch fused with the occipital bone. Bilateral fusion of transverse process with occipital bone was noted in 2 (10%) specimen. The incomplete foramen transversarium was found in 1 skull (5%) {bilateral} and in 2 skulls (10%), the transverse process was noted without the foramen transversarium {bilateral}.
Conclusion: Out of 1000 examined skulls, fusion of atlas with the occipital bone was noted in 20 skulls (2%). The knowledge of incidence of assimilation of atlas and its variations may be helpful for the embryologist, neurosurgeons and orthopedic surgeons.
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References
Jayanthi V, Kulkarni R. Atlanto-occipital fusion. Report of two cases. J Anat Soc India. 2003;52(I):71-3.
Ranade AV, Rai R, Prabhu LV, Kumaran M, Pai MM. Atlas assimilation: a case report. Neuroanatomy. 2007;6:32-3.
Goel A, Sharma P, Dange N, Kulkarni AG. Techniques in the treatment of craniovertebral instability. Neurol India. 2005;53:525-33.
Nayak S, Vollala V, Raghunathan D. Total fusion of atlas with occipital bone. Neuroanatomy. 2005;4:39-40.
Ugar DA, Semb. The prevalence of anomalies of the upper cervical vertebrae in subjects with cleft lip, cleft palate, or both. Cleft Palate Craniofac J. 2001;38:498-503.
Macalister A. Notes on the development and variations of the atlas. J Anat Physiol. 1893;27:519-42
McRae, Barnum AS. Occipitalisation of atlas. Am J Roentgen. 1953;70:23-46.
AL-Motabagani MA, Surendra M. Total occipitalization of the atlas. Anat Sci Int. 2006;81:173-80.
Gladstone RJ, Erichsen-Powel W. Manifestation of occipital vertebrae and fusion of atlas with the occipital bone. J Anat Phy. 1915;59:190-209.
Green HLHH. An unusual case of atlanto-occipital fusion. J Anat. 1930;65:140-4.
Lanier RR Jr. An anomalous Cervico-occipital skeleton in man. Anat Rec. 1939;73:189-201.
Shane Tubbs R, Gearage Salter E, Jerry Oakes W. The intracranial entrance of the atlantal segment of the vertebral artery in crania with Occipitalisation of the atlas. Journal of neurosurgery. Spine. 2006 Apr;4:4.
Yochum TR, Rowe LJ. Developmental disorder. In: Yochum TR, Rowe LJ, eds. Essentials of Skeletal Radiology. 2nd ed. Baltimore: William and Wilkins; 1987: 3.
Mayhew IG, Watson AG, Heissan JA. Congenital occipitoatlanto axial malformation in the horse. Equine Vet J. 1978;10:103-13.
Van Nie CJ, Folkerts, JF. Occipitalisation of the atlas in a sheep. Acta Morphol Neere Scand. 1977;15:325.
Taitz C. Bony observation of some morphological variation and anomalies of the cranio-vertebral region. Clin Anat. 2000;13:354-60.
Lang J. Craniocervical region osteology and articulation. Neuro-orthopedics. 1986;1:67-92.
Bergman P. Varieties of atlas in man. Folio Morphol Warsaw. 1967;26:129-39.
Smith CA, Tuan RS. Human PAX gene expression and development of vertebral column. Clin Orthop Relat Res. 1994;302:241-50.
Vineeta Saini, Royana Singh, Manimay Bandopadhyay, Sunil Kumar Tripathi, Satya Narayan Shamal. Occipitalization of atlas: its occurrence and embryological basis. Int J Aanat Variat. 2008;2:85-8.
Sharma M, Singh B, Abhaya A, Kumar H. Occipitalization of atlas with other associated anomalies of skull. Eur J Anat. 2008;12(3):159-67.
Kimaporn Khamanarong, Worawut Woraputtaporn, Somsiri Ratanasuwan, Malivalaya Namking, Wunnee Chaijaroonkhanarak, Surachai Sae-Jung. Occipitalization of the atlas: its incidence and clinical implications. Acta Medica Academica. 2013;42(1):41-5.
Hussain Saheb S, Mavishetter GF, Thomos ST, Prasanna LC, Muralidhar P. Occipitalization of atlas: a case report. J Biomed Sci Res. 2010;2(2):73-5.
Satheesha Nayak. Asymmetric atlas assimilation and potential danger to the brainstem: a case report. Int J Biol Anthropol. 2008;1(2):4.
Gholve PA, Hosalkar HS, Ricchetti ET, Pollock AN, Dormans JP, Drummond DS. Occipitalization of the atlas in children. Morphologic classification, associations, and clinical relevance. J Bone Joint Surg Am. 2007;89(3):571-8.
Gholve PA, Hosalkar HS, Ricchetti ET, Pollock AN, Dormans JP, Drummond DS. Occipitalization of the atlas in children. Morphologic classification, associations, and clinical relevance. J Bone Joint Surg Am. 2007;89(3):571-8.
Anu Vinod Ranade, Rajalakshmi Rai, Latha Venkatraya Prabhu, Mangala Kumaran, Mangala M. Pai. Atlas assimilation: a case report. Neuroanatomy. 2007;6:32-8.
Surekha Jadhav, Manoj Ambali, Raosaheb Patil, Megha Doshi, Priya Roy. Assimilation of atlas in Indian dry skulls. J Krishna Inst Med Sci Univ. (JKIMSU). 2012;1:102-6.