IJAR.2022.312
Type of Article: Original Research
Volume 11; Issue 1 (March 2023)
Page No.: 8583-8586
DOI: https://dx.doi.org/10.16965/ijar.2022.312
Study of Incidence of Ponticulus Posterior In Dry Human Atlas Vertebra and Its Clinical Significance
Ashish Kamdi 1, Hemlata Ambade 2, Gourav Thakre 3, Ashita Kaore *4, N.Y.Kamdi 5.
1 Associate Professor, Department of Anatomy, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chattisgarh, India.
2 Assistant Professor, Department of Anatomy, Government Medical College, Nagpur, Maharashtra, India.
3 Associate Professor, Department of Anatomy, Dr Babasaheb Ambedkar Medical College, Rohini New Delhi, India.
*4 Assistant Professor, Department of Anatomy, Government Medical College, Nagpur, Nagpur, Maharashtra, India.
5 Professor and Head, Department of Anatomy, Government Medical College, Nagpur, Nagpur, Maharashtra, India.
Corresponding Author: Dr Ashita Kaore, Assistant Professor, Department of Anatomy, Government Medical College, Nagpur, Maharashtra, India. E-mail: kaoreashita@gmail.com
ABSTRACT
Background: Atlas is the first cervical vertebra. The vertebral artery lies in the groove on posterior arch of the atlas. The vertebral artery groove may sometimes get converted into a foramen. This is commonly known as ponticulus posterior (ponticulus posticus) or arcuate foramen of the atlas. These foramina may be complete or incomplete. This can lead to compression of the vertebral artery and produce symptoms like headache, syncope, altered consciousness etc. It can also complicate manipulations of the cervical spine by reducing the blood flow during extreme rotations of head and neck. It is also associated with vertebrobasilar artery stroke So, neurosurgeons or orthopaedic surgeons who operate in this area should have a detailed knowledge of variations of groove for the vertebral artery.
Materials and Methods: The present study was conducted on 50 dried and fully ossified adult human atlas of unknown age and sex collected from the department of Anatomy, Government Medical college, Nagpur. Each atlas vertebra was carefully observed for the presence or absence of complete or incomplete ponticuli on superior surface of posterior arch of atlas.
Results: Out of the 50 vertebra studied 7(14%) showed the presence of Ponticuli. Ponticuli were incomplete in all 7 atlas vertebras. Complete ring was not observed in any of the atlas vertebra .Out of the 7 ponticuli 6(12%) were found to be unilateral and in only 1 (2%) case it was found to be bilateral. Out of the 6 ponticuli 4(8%) were noticed on the Left side and 2(4%) were present on the right side.
Conclusion: Presence of incomplete ponticulus posterior might cause cervical pain and even cerebrovascular disorders due to pressure on third part of vertebral artery present in the vertebral artery groove. This anatomical knowledge is important for neurosurgeons, orthopaedic surgeons, radiologists and clinicians while dealing with this region.
KEYWORDS: Ponticulus Posterior, Atlas, Cervical Vertebra, Cerebrovascular disorders, Vertebral artery.
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