An Osteological Study of Anatomical Variations of Foramen Transversarium of Cervical Vertebrae and its Clinical Implications

Background: In cervical vertebrae, the costal and transverse elements are connected to each other around the foramen transversarium of the transverse process. The adult cervical vertebrae are characterized by the presence of Foramen Transversarium (FT) in transverse process. These transverse foramina are found to have variations in size, shape and numbers and may be absent, incomplete or duplicate, which may lead to various symptoms. Aim: To study the anatomical variations of cervical vertebrae. Materials and methods: The present observational study was performed on 182 dry human cervical vertebrae of unknown sex and age. Intact cervical vertebrae without any degenerative or traumatic disorders were included in this study. Deformed and damaged vertebrae were excluded from the study Results: Out of these 364 foramen transversarium, 98 (27%) foramen transversarium were of type-I. Type -I was the most common presentation in the present study. Type -II foramen transversarium were seen in 33 (09%) foramen transversarium. Out of 364 foramen transversarium 88 (24%) foramen transversarium were of type-III. Type-IV foramen transversarium were seen in 62 (17%) foramen transversarium. Type-V foramen transversarium were seen on 83 (23%) foramen transversarium. Out of 182 vertebrae 40 (22%) showed complete double foramen transversarium. Incomplete double foramen transversarium were seen in 24 (13%) of vertebrae. One side complete & other side incomplete foramen transversarium were seen in 04 (02%) vertebrae. Conclusion: Knowledge of such variations is important for Physicians, Neurologists Otorhinolaryngologists, radiologists and Orthopedicians. Presence of accessory foramen transversarium especially of incomplete variety, the second part of vertebral artery may be dislodged and prone to get damaged easily during posterior cervical injuries. It helps in radiological imaging, neurological diagnosis and complex surgical procedures in the cervical area. KEY WORDS: Cervical Vertebrae, Foramen transversarium, Accessory Foramen Transversarium.

STUDY OF ACCESSORY SUPRAORBITAL FORAMEN IN NORTH INDIAN HUMAN SKULL

Objective: This research was aimed at telling the anatomical characteristics of the accessory supraorbital foramen (ASOF) in relation to the main supraorbital foramen (SOF), which is necessary in clinical situations that require regional surgical procedures. Methods: A total dedicated to the presence and location of 72 dry Indian adults of unknown age and sex were investigated. In each skull, the ASOF location was measured on both sides with a Vernier caliper metal case, with the SOF as the reference point. The total number of accessory foramen was also noted. Results: Accessory infraorbital foramens (IOFs) were seen only in 4.16% in our study and all seen were single in number. Half of those accessory foramen were present on medial and rest half were present on superomedial position as compared to the main IOF. Half among present accessory foramens were located at a distance of <2 mm and half were located at a distance of more than 2 mm. The mean location of accessory IOF was at 7.07 mm from main IOF. Conclusion: Knowledge of the anatomical characteristics of ASOF can have major effects on surgical and local anesthetic preparation blockage of the super orbital nerves. Additional guidance for surgeons may be provided with information on the foramens obtained from this study. The surgeons should note this during the nerve block as damage to either branch will lead to sensory impairment and incomplete blocking of the nerve.

Variations of Foramen Transversarium in Typical Cervical Vertebrae

The cardinal feature of cervical vertebrae is the foramen transversarium, which transmits the vertebral artery, its accompanying vein and a sympathetic plexus from the inferior cervical ganglion. The aim of the present study was to observe the variations in the size and shape and number of foramen transversarium of typical cervical vertebrae. The study material consisted of 176 typical cervical vertebrae of unknown sex and origin, taken from adult dried human bones present in archieve of department of anatomy. The maximum and minimum mean diameters of the foramen transversarium on the right side were 6.54 mm and 5.39 mm respectively. On the left side, the maximum and minimum mean diameters of the foramen transversarium were 6.28 mm and 5.27 mm respectively. The difference of parameters on the right & left side was statistically insignificant. In no case was the foramen transversarium absent though it was asymmetrical in two cervical vertebrae. Accessory foramen transversarium were present in 11 cervical vertebrae which were present bilaterally in 7 and unilaterally in 4 vertebrae (1 right-sided and 3 left-sided). These accessory foramina could be due of remnants of costal element or due to variations in the vertebral vessels. The anatomical knowledge of the variations in the F.T of cervical vertebrae can be of importance to the neurologists, clinicians and radiologists for proper interpretation of X-rays and CT scans. This knowledge can also play an important role in identification of the dead bodies if ante mortem radiographs of the deceased are available for comparison.