Xi Lin1,2, Hou-Jun Zhu3, Yang Xu4,5, Ting Zheng6,7, Fei-Yue Lin1,2, Xiao-Ming Yin1,2. 1. Shengli Clinical Medical College of Fujian Medical University, Fu Zhou, China. 2. Department of Orthopedics, FuJian Provincial Hospital, DongJie Road 134, Fu Zhou, 350001, People's Republic of China. 3. Penglai People's Hospital, Yan Tai, 265600, People's Republic of China. 4. Shengli Clinical Medical College of Fujian Medical University, Fu Zhou, China. 303738717@qq.com. 5. Department of Orthopedics, FuJian Provincial Hospital, DongJie Road 134, Fu Zhou, 350001, People's Republic of China. 303738717@qq.com. 6. Shengli Clinical Medical College of Fujian Medical University, Fu Zhou, China. 401878351@qq.com. 7. Department of Anesthesiology, FuJian Provincial Hospital, DongJie Road 134, Fu Zhou, 350001, People's Republic of China. 401878351@qq.com.
Abstract
BACKGROUND: The presence vertebral artery (VA) abnormalities in the upper cervical may be a potential cause of catastrophic complication in the posterior approach of the upper cervical spine surgery. The aim of this study was to demonstrate the real incidence of the V3 segment anomaly in patients who need upper cervical surgery, and tried to find out the risk factors of V3 segment anomaly to evaluate the necessary of computed tomographic angiography (CTA) for upper cervical surgery. METHOD: This systematic review was conducted following the preferred reporting items for systematic reviews and meta-Analyses (PRISMA). Retrospective studies and reports of case series involving human subjects with data on anomalies of vertebral artery in upper cervical spine were included. Data on the prevalence of persistent first intersegmental artery (PIA), fenestration of the VA (FA), posterior inferior cerebellar artery (PICA) were extracted. RESULTS: A total of 16 articles involving 5927 subjects met the inclusion criteria. The total incidence of V3 segment anomaly in the patients with bony abnormalities was 25.9% (74/286): PIA was 17.5%, FA was 6.6% and PICA was 1.8%. The total incidence of V3 segment anomaly in the patients without bony abnormalities was 2.7% (152/5671): PIA was 1.76%, FA was 0.4% and PICA was 0.5%. The total incidence of V3 segment anomaly in Asian population without bony abnormalities was 5.8%, while in European and American population was 0.8 and 0.6%, respectively. CONCLUSION: Patients with bone abnormalities are high risk factor for VA abnormalities, CTA is of paramount importance to evaluate the variant VA anatomy. However, regarding to the low incidence of V3 variation in normal population, we do not recommend preoperative CT angiography as mandatory part of preoperative.
BACKGROUND: The presence vertebral artery (VA) abnormalities in the upper cervical may be a potential cause of catastrophic complication in the posterior approach of the upper cervical spine surgery. The aim of this study was to demonstrate the real incidence of the V3 segment anomaly in patients who need upper cervical surgery, and tried to find out the risk factors of V3 segment anomaly to evaluate the necessary of computed tomographic angiography (CTA) for upper cervical surgery. METHOD: This systematic review was conducted following the preferred reporting items for systematic reviews and meta-Analyses (PRISMA). Retrospective studies and reports of case series involving human subjects with data on anomalies of vertebral artery in upper cervical spine were included. Data on the prevalence of persistent first intersegmental artery (PIA), fenestration of the VA (FA), posterior inferior cerebellar artery (PICA) were extracted. RESULTS: A total of 16 articles involving 5927 subjects met the inclusion criteria. The total incidence of V3 segment anomaly in the patients with bony abnormalities was 25.9% (74/286): PIA was 17.5%, FA was 6.6% and PICA was 1.8%. The total incidence of V3 segment anomaly in the patients without bony abnormalities was 2.7% (152/5671): PIA was 1.76%, FA was 0.4% and PICA was 0.5%. The total incidence of V3 segment anomaly in Asian population without bony abnormalities was 5.8%, while in European and American population was 0.8 and 0.6%, respectively. CONCLUSION: Patients with bone abnormalities are high risk factor for VA abnormalities, CTA is of paramount importance to evaluate the variant VA anatomy. However, regarding to the low incidence of V3 variation in normal population, we do not recommend preoperative CT angiography as mandatory part of preoperative.
Authors: R F Heary; T J Albert; S C Ludwig; A R Vaccaro; L J Wolansky; T P Leddy; R R Schmidt Journal: Spine (Phila Pa 1976) Date: 1996-09-15 Impact factor: 3.468
Authors: Richard J Solomon; Madhu K Natarajan; Serge Doucet; Samin K Sharma; Cezar S Staniloae; Richard E Katholi; Joseph L Gelormini; Marino Labinaz; Abel E Moreyra Journal: Circulation Date: 2007-06-11 Impact factor: 29.690