title: A morphometric anatomical and comparative study of the foramen magnum region in a Greek population.
abstract: BACKGROUND
  The foramen magnum (FM), a complex area in craniocervical surgery, poses a challenge for neurosurgeons. The knowledge of the detailed anatomy of the FM, occipital condyles (OC) and variations of the region is crucial for the safety of vital structures. This study focuses on the FM and OC morphometry, highlights anatomical variability and investigates correlations between the parameters studied.
  
  
  METHODS
  One hundred and forty-three Greek adult dry skulls were examined using a digital sliding calliper (accuracy, 0.01 mm).
  
  
  RESULTS
  Mean FM width and length were found 30.31 ± 2.79 and 35.53 ± 3.06 mm, respectively. The commonest FM shape was two semicircles (25.9 %), whereas the most unusual was irregular (0.7 %). The OC minimum width, maximum width and length were 5.71 ± 1.61, 13.09 ± 1.99 and 25.60 ± 2.91 mm on the right, and 6.25 ± 1.76, 13.01 ± 1.98 and 25.60 ± 2.70 mm on the left side. The commonest OC shape was S-like and the most unusual was ring, bilaterally. The mean anterior and posterior intercondylar distances were 19.30 ± 3.25 and 51.61 ± 5.01 mm, respectively. The OC protruded into the FM in 86.7 % of the skulls. Variations such as a third OC existed in 5.6 % and basilar processes in 2.8 %. Posterior condylar foramina were present in 75.5 %. The gender was correlated with FM width and length, OC length, bilaterally, anterior intercondylar distance (AID) and posterior intercondylar distance (PID). The OC protrusion and existence of posterior condylar foramina were correlated. Bilateral asymmetry for OC shape was statistically significant.
  
  
  CONCLUSIONS
  Our results provide useful information that will enable effective and reliable surgical intervention in the FM region with the maximum safety and widest possible exposure.
authors.affiliation: Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Plateia Ippodromiou 17, 54621, Thessaloniki, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Natsis
authors.forename: M
authors.initials: M
authors.lastname: Piagkou
authors.forename: G
authors.initials: G
authors.lastname: Skotsimara
authors.forename: G
authors.initials: G
authors.lastname: Piagkos
authors.forename: P
authors.initials: P
authors.lastname: Skandalakis
mesh_terms: D000328:Adult; D002102:Cadaver; D002508:Cephalometry; D005260:Female; D005539:Foramen Magnum / Q000033:anatomy & histology*; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000033:anatomy & histology*; D012494:Sampling Studies; D012737:Sex Factors