Morphological features and anatomical variations of the Foramen Transversarium in Cervical vertebrae: A study in Eastern Indian population

Abstract

Introduction: The foramina transversaria (FT) is a cardinal feature of the Cervical Vertebra. It transmits the vertebral vascular bundle (vertebral artery, and veins) and the sympathetic plexus which accompanies the vessels. Variations in number, size, shape & other morphological details of foramen transversarium give rise to neurological as well as hearing impairment. We in the index study, deliberated over the variations of FT as well as accessory FT. This in turn will help neurology surgeons as well as orthopedic surgeons while performing surgeries on the cervical spine. Objectives: Study of variations in number, size, shape & other morphological details of foramen transversarium in order to facilitate spinal surgery of cervical vertebra. Materials and Methods: A cross sectional, single center, observational study was conducted in a tertiary care hospital with 160 sets, exactly 1099 human cervical vertebrae. All cervical vertebrae were observed macroscopically, on both the sides for presence of: Variations in number, size, shape & other morphological details of foramen transversarium. Variations in number, size, shape & other morphological details of accessory foramen transversarium. Results: According to our observation type 4 is the most prevalent category in the right side (39.67%); whereas type 5 (30.12%) is the commonest category in the left side, being closely seconded by type 1(28.57%). The incidence of AFT (Accessory Foramina Transversarium) varied from 2.5% to 17.61 %. There is progressive increase in incidence from C1 to C7 except C2 where the incidence was zero. Conclusion: The data provided by the present study on the morphology of foramen transversarium can be helpful in the interpretation of radiographic pictures and in computerized tomography for the diagnostic purposes. They may also be of assistance in determining a more accurate surgical approach to the removal of osteophytes or spurs compressing the vertebral arteries, or for other interventions in that area.