Korean J Pain.  2014 Jul;27(3):266-270. 10.3344/kjp.2014.27.3.266.

Variations in Entrance of Vertebral Artery in Korean Cervical Spine: MDCT-based Analysis

• Shin HY
• Park JK
• Park SK
• Jung GS
• Choi YS

• KMID: 2278238
• DOI: http://doi.org/10.3344/kjp.2014.27.3.266

Abstract

BACKGROUND
Knowledge of the anatomical variation of the vertebral artery has clinical importance not only for the performance of interventional or surgical procedures itself but also to ensure their safety. We conducted a study of the anatomical variation by reviewing multi-detector computed tomography (MDCT) images of the cervical spine from 460 Korean patients.
METHODS
16-row MDCT data from 460 patients were used in this study. We observed 920 vertebral arteries. Examination points included level of entrance of the artery into the transverse foramen of the cervical vertebra, origin site of the vertebral artery, course of a vertebral artery with aberrant entrance. RESULT: The vertebral artery in 2 (0.2%) cases in this study entered into the transverse foramen of the 7th cervical vertebra from the left. In 45 (4.9%) cases, the vertebral artery entered into the transverse foramen of the 5th cervical vertebra. Of these, the entrance was on the right in 15 (1.6%) and on the left in 30 (3.3%). We found 17 (1.8%) cases in which the artery entered into the transverse foramen of the 4th cervical vertebra, 10 (1.1%) on the right and 7 (0.7%) on the left side. As is commonly acknowledged, the 6th cervical vertebra was the most common site of entry; the vertebral artery entered the transverse foramen of the 6th cervical vertebra in the remaining 855 (93.0%) cases, on the right in 434 (47.2%) and on the left in 421 (45.8%).
CONCLUSIONS
In conclusion, the possibility of an atypical course of the vertebral artery in segments V1 and V2 should be evaluated with magnetic resonance imaging (MRI) or CT images before carrying out procedures involving the anterior cervical vertebrae.

Keyword

cervical spine; multi-detector computed tomography; vertebral artery

MeSH Terms

Arteries
Cervical Vertebrae
Female
Humans
Magnetic Resonance Imaging
Spine*
Vertebral Artery*

Figure

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  Fig. 1 Four parts of vertebral artery.

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  Fig. 2 Variations of entering level of vertebral artery (arrow). (A) C5 entrance, (B) C4 entrance, (C) C3 entrance.

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  Fig. 3 Retrothyroid course of atypical vertebral artery (VA, arrow). (A) right VA, axial image, (B) right VA, sagittal image, (C) left VA, axial image, (D) left VA, sagittal image.

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