Bipartition of the atlanto-occipital joint surfaces in a South African sample

Abstract

BackgroundOne variation of the atlanto-occipital joint contains a groove or crest dividing the superior articulating facet of C1 and/or the corresponding occipital condyle. This study aimed to estimate the prevalence of bipartition of the facets associated with the atlanto-occipital joint and to determine the relationships between the corresponding joint surfaces, bilateral and unilateral facets as well as demographic factors in a South African sample. Materials and methodsData about shape and bipartition found on the superior articular facets of the atlas and the occipital condyles were collected from 109 skulls and atlases from the Pretoria Bone Collection, South Africa. Shape data was categorically classified according to existing criteria from literature. ResultsThe results revealed the occasional occurrence of a double facet at both the superior articular facet of the atlas (15.6 %), and the occipital condyle (7.34 %). Shape and facet number of the superior articulating facet and corresponding occipital condyle were significantly correlated. The prevalence of bipartition of neither the superior articular facets nor the occipital condyles were statistically significantly different between the left and right sides. Sex and age did not statistically significantly contribute to prevalence of bipartition in this population. However, population group statistically significantly contributed to prevalence of bipartition (p = 0.019), with the White South African sample having a much higher prevalence (88.24 % superior articulating facet, 100 % occipital condyle) of bipartition compared to the Black South African sample (11.76 % superior articular facet, 0 % occipital condyle). ConclusionAwareness of this joint variation and instances where it is more likely to occur may be valuable for neuro-vascular and orthopaedic surgeons when doing invasive treatments around the craniocervical junction, and chiropractors when assessing and treating patients.