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External occipital protuberance classification with special reference to spine type and its clinical implications

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Abstract

Purpose

This investigation aimed to study the types of external occipital protuberance (EOP) with special reference to Type 3 (spine type). Detailed information will be useful for clinicians to manage occipital headaches or issues related to the biomechanics of the neck and for accurate radiological interpretations.

Methods

Thirty-one dry intact cadaveric skulls were studied for EOP classification. In Type III EOP cases, the size of EOP was noticed using different modalities and compared. The superior nuchal lines and external occipital crest were observed for their prominence and any variation.

Results

42% of the skulls belong to Type 1, 51.5% to Type 2, and 6.5% to Type 3 EOP. Superior nuchal lines and external occipital crest were more prominent in Types 2 and 3 EOP. In Type 3 EOP cases, the mean length, width, and thickness of the spine as measured directly on the skull were 16.63 mm; 20.1 mm, and 7.82 mm respectively, the same as radiograph findings. CT examination revealed the average volume as 0.95 cm3. Out of two Type 3 EOP cases, the spine with larger values for its size was having a lesser volume value in CT.

Conclusions

Plain lateral radiography is a reliable method to measure the length and thickness of spinous EOP. However, more values of these parameters for morphometry of the EOP spine do not mean more volume of EOP and vice versa. Detailed information regarding the occurrence of occipital spur and its morphology will be of great importance to neurosurgeons, sports, physicians, emergency departments, and radiologists.

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Availability of data and materials

The data are available on request, from the corresponding author.

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Acknowledgements

The authors sincerely thank those who donated their bodies to science so that anatomical research and teaching could be performed. Results from such research can potentially increase scientific knowledge and can improve patient care. Therefore, these donors and their families deserve our highest respect [4].

Funding

Not Applicable.

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Authors and Affiliations

  1. Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India

    Anjali Singal & Priti Chaudhary

  2. Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, 151001, India

    Paramdeep Singh

Authors
  1. Anjali Singal
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  2. Priti Chaudhary
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  3. Paramdeep Singh
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Contributions

AS: Project development, Data collection, Data analysis and management, manuscript writing, approval of the final version. PC: Data management, Data analysis, approval of the final version. PS: Project development, Data analysis, manuscript editing, approval of the final version.

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Correspondence to Anjali Singal.

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Authors declare no competing interests.

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The study is approved by Institutional Ethical Committee.

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Singal, A., Chaudhary, P. & Singh, P. External occipital protuberance classification with special reference to spine type and its clinical implications. Surg Radiol Anat 45, 555–561 (2023). https://doi.org/10.1007/s00276-023-03133-8

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  • DOI: https://doi.org/10.1007/s00276-023-03133-8

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