Age-related morphologic changes of the vertebral artery in the transverse process. Analysis by multidetector computed tomography angiography.
BACKGROUND
The V2 segment of the vertebral artery (VA) ascends and passes through the transverse foramen (TF) of the C6-C1 vertebrae. Atherosclerosis of the VA and degenerative changes in the cervical spine are likely to occur with aging, and subsequent morphologic changes may alter the normal anatomy.


OBJECTIVE
The aim was to determine the morphologic changes of TF and VA in relation to aging.


METHODS
This was a retrospective cross-sectional study.


METHODS
One hundred ten consecutive patients who had undergone computed tomography angiography were included.


METHODS
The subjects were then divided into three groups according to age: Group A, less than 45 years; Group B, from 45 to 65 years; and Group C, older than 65 years. Cases with stenosis and dissection of the VA were excluded from the quantitative analysis. The areas of the VA and TF were measured, and the VA/TF occupation ratio (OR) was calculated accordingly. The presence of VAs tortuosity within the TF was also noted.


RESULTS
The TF was larger in the oldest group, but the difference was not statistically significant. There was also no significant statistical difference among the age groups in terms of the VA and VA/TF ORs (p>.05). In the Group C, the rate of overall tortuosity of the VA was 73%, and arterial tortuosity in the TF was 28.6%. In cases with tortuous VA, C6 and C4 TFs were found to be significantly larger.


CONCLUSIONS
Tortuous VAs tend to be associated with enlargement of C6 and C4 TFs. Knowledge of such changes in the anatomy is crucial during instrumentation used for cervical spine surgeries, to prevent serious complications in patients aged older than 65 years.
Department of Radiology, Near East University Medical Faculty, Nicosia / TRNC, Mersin 10 Turkey; Department of Anatomy, Gazi University Medical Faculty, Bahriye Üçok Caddesi Ankara/Çankaya, Turkey. Electronic address: alicioglu.b@gmail.com.
Banu
B
Alicioglu
Department of Anatomy, Gazi University Medical Faculty, Bahriye Üçok Caddesi Ankara/Çankaya, Turkey.
Nadir
N
Gulekon
Department of Radiology, Near East University Medical Faculty, Nicosia / TRNC, Mersin 10 Turkey.
Suha
S
Akpinar
D000328:Adult; D000368:Aged; D000792:Angiography; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000254:growth & development*
Aging; Anatomy; Cervical spondylosis; Cervical vertebrae; Computed tomography angiography; Vertebral artery