Abstract
Objectives: The morphometric changes in the vertebral artery are essential for various interventions. Inadequate details about it can lead to risk of vertebral artery injury and other complications. This study explains the normal anatomical course of V2 segment of vertebral artery which is more prone for iatrogenic injury.
 Materials and Method: 25 adult patients with symptomatic neck pain were involved in the study. Various measurements were made from seventh cervical vertebra (C7) to the third cervical vertebra (C3) that included Distance from midline to VA, Distance from medial margin of Longus Colli to VA, Perpendicular distance from anterior margin of transverse process to center of VA, Horizontal distance from anterior tubercle to VA, sagittal and coronal diameter of the transverse foramen and vertebral artery.
 Result: Distance from midline, Distance from medial margin of Longus Colli, Perpendicular distance from anterior margin of transverse process to center of VA and Horizontal distance from anterior tubercle were increased towards right compared to left side. The sagittal and coronal diameter of the transverse foramen and vertebral artery decreased from C6 to C3 vertebra. Vertebral artery dominance was seen on left side in all cases.
 Conclusion: Preoperative assessment by computed tomography angiography helps to know the course of the vertebral artery, understand its patterns and assess various abnormalities thereby aids in preventing complications in future surgeries.
Highlights
Morphometric variations of the vertebral artery are significant for diagnostic and surgical interventions [1]
Vertebral artery entered the transverse foramen of sixth cervical vertebra (C6) in all 25 adults involved in the study
Perpendicular distance from anterior margin of transverse process to center of vertebral artery was increased in the right side (5.76 ± 0.87 mm) when compared to the left side (4.79 ± 0.81 mm)
Summary
Morphometric variations of the vertebral artery are significant for diagnostic and surgical interventions [1]. The vertebral artery comprises of 4 segments. The first of the 4 segments (V1) arise from the subclavian artery to the transverse process of sixth cervical vertebra (C6). The second segment of the vertebral artery (V2) arises superiorly through the transverse foramen of the sixth cervical vertebra (C6) until it reaches the transverse process of the axis vertebra (C2). The incidence of anatomical variation of V2 segment of vertebral artery is high [5]. Anomalous V2 segment of vertebral artery have been reported in few publications. It states that about 10% of study population has abnormalities [3,4,5,6]
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