Morphological Variations Of The Craniovertebral Junction In A Kenyan Population

A Cross Sectional Radiological Study

Abstract

Importance: Variant anatomy of the craniovertebral junction may present with various neurological manifestations and also complicate surgical access to lesions. Objective: To determine the variant anatomy of the neural arch of the atlas. Methods: Cross-sectional survey of 116 patients (equal numbers of males and females) done between August and October 2021 at the Kenyatta National Hospital. Bone window and 3D reconstructions of the CVJ formats of axial CT scans centred on the base of the skull of patients undergoing routine head and neck imaging were  analyzed. The presence and completeness of the posterior ponticulus and posterior arch defects were determined. Results: Type A posterior arch defects had a prevalence of 6.8%. The prevalence of complete posterior ponticuli was at 15%, with unilateral ponticuli more common than bilateral ones (twelve versus six). There was no gender difference in terms of distribution. Conclusion: Variations of the posterior arch of the atlas are relatively high in the Kenyan setup, necessitating a low threshold for imaging before surgery with a keen analysis.