title: Variation of bilateral transverse ligament tubercles with age and gender in a large series of subjects on multidetector computed tomography.
abstract: BACKGROUND
  The transverse ligament tubercles play an important role in maintaining the stability of upper cervical spine, but the variation of these tubercles with aging has not been studied systematically.
  
  
  OBJECTIVE
  To evaluate the variation of the height of the transverse ligament tubercles with respect to age and gender, and assess side-to-side differences on multidetector computed tomography (MDCT).
  
  
  METHODS
  A consecutive series of 291 Chinese patients undergoing a head or neck MDCT were divided into eight age groups. The bony anatomy of the atlas was displayed symmetrically by aligning the axial plane and the mean height of bilateral transverse ligament tubercles was measured. The height was correlated with age and gender and side-to-side differences were analyzed. Finally, the inter-observer performance was assessed.
  
  
  RESULTS
  No transverse ligament tubercles were seen in 51 cases (17.5%, 51/291) and unilateral transverse ligament tubercles were seen in two cases (0.7%, 2/291). Bilateral transverse ligament tubercles were observed in 238 cases (81.8%, 238/291). The average height of the left and right tubercles were 2.68 ± 1.58 mm and 2.68 ± 1.54 mm, respectively, with no significant side-to-side differences (t = 0.061, P > 0.05). The height was also similar in both genders (left: t = 0.497, P > 0.05, right: t = 0.730, P > 0.05). The height increased linearly with age (left: r = 0.513, P < 0.05, right: r = 0.516, P < 0.05). The inter-observer reliability was excellent.
  
  
  CONCLUSIONS
  The height of the transverse ligament tubercles on MDCT linearly increases with increasing age with no significant differences among the genders or the side measured.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Yongguang
authors.initials: Y
authors.lastname: Ban
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Qinhua
authors.initials: Q
authors.lastname: Luan
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China panzhuangliukai@163.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Ximing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Sun
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Musculoskeletal Radiology UT Southwestern Medical Center, Dallas, TX, USA Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Avneesh
authors.initials: A
authors.lastname: Chhabra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001268:Atlanto-Axial Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D007223:Infant; D008023:Ligaments, Articular / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies
keywords: Atlas; height; multidetector computed tomography (MDCT); spine; transverse ligament tubercle