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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Incidence and Clinical Significance of Ponticulus Posterior in Dry Human Atlas
Dr. Swagatika Pradhan, Dr. Sushanta Kumar Bhoi, Dr. Dhiren Panda, Dr. Pratima Baisakh, Dr. Sitanshu Kumar Panda

Background: The first cervical vertebra is called Atlas. The atlas's posterior arch has a groove where the vertebral artery is located. Sometimes, the vertebral artery groove might change into a foramen. This is also referred to as the arcuate foramen of the atlas or ponticulus posterior (ponticulus posticus). These foramina could be full or empty. This might cause the vertebral artery to get compressed, which can result in symptoms including headaches, syncope, altered awareness, etc. By limiting blood flow during excessive rotations of the head and neck, it can also make cervical spine manipulation more difficult. It is linked to vertebrobasilar artery stroke as well. The variations of grooves for the vertebral artery should therefore be thoroughly understood by neurosurgeons and orthopaedic surgeons who practise in this region. Materials and Methods: The Department of Anatomy, IMS and SUM Hospital, SOA University Bhubaneswar, Odisha, provided 100 fully ossified adult human atlases that were dried and collected for this investigation. The atlases were of unknown age and sex. On the superior surface of the posterior arch of the atlas, each atlas vertebra was carefully examined for the presence or absence of complete or incomplete ponticuli. Results: In the 100 vertebrae that were analysed, 14 (14% of them) had ponticuli. There were no ponticuli in any of the 14 atlas vertebrae. None of the atlas vertebra showed a complete ring. Only two (2%) of the 14 ponticuli were discovered to be bilateral, with 12 (12%) of them being unilateral. 8 (or 8%) of the 12 ponticuli were found on the left side and 4 (or 4%) on the right. Conclusion: Due to pressure on the third part of the vertebral artery, which is located in the vertebral artery groove, the presence of an incomplete ponticulus posterior may result in cervical pain and potentially cerebrovascular diseases. When treating patients in this area, radiologists, orthopaedic surgeons, neurosurgeons, and doctors need to be aware of the relevant anatomical information.

 
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