Abstract
The occipital condyle (OC) is an important area in craniovertebral surgery, but neither its anatomical features nor the procedures concerning the OC have been detailed yet. The morphological analysis of the structures were made in totally 704 sides of the occipital bones of adult skulls by 3D-Doctor Demo version. The length and width of the OC were found to be 23.9 ± 3.4 (right), 24 ± 3.3 (left) and 11.9 ± 2.3 (right), 10.7 ± 2.3 mm (left), respectively. The mean anterior intercondylar distance and the posterior intercondylar distance were measured as 20.9 ± 3.6 and 43.1 ± 4 mm, respectively. The sagittal intercondylar angle was observed as 68.7 ± 10.6º. The sagittal condylar angle was observed to be 32.9 ± 7.6º and 38.2 ± 7.3º in the right and left, respectively. The head circumference was observed to be 65.6 ± 7.8 and 64.4 ± 7.2 mm in the right and left, respectively. The head area was measured as 231.9 ± 53.3 and 214.9 ± 45.1 mm² in the right and left, respectively. The most common type was oval-like (59.67%), whereas the most unusual one was two-portioned condyle (0.32%). In Pearson correlation analysis, it was significant that a statistically strong relation was noticed between the length and area, and the circumference and area. The findings suggest that the oval type was more successful to work with, while the triangular, circular and two-portioned types were highly risky for the fixation resonance as the surface got quite smaller. As a result, we suggest that by resecting nearly half of the OC, the border of the hypoglossal canal can be involved.
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References
Acikbas SC, Tuncer R, Demirez I, Rahat O, Kazan S, Sindel M, Saveren M (1997) The effect of condylectomy on extreme lateral transcondylar approach to the anterior foramen magnum. Acta Neurochir (Wien) 139(6):546–550
Barut N, Kale A, Suslu HT, Ozturk A, Bozbuga M, Sahinoglu K (2009) Evaluation of the bony landmarks in transcondylar approach. Br J Neurosurg 23(3):276–281
Bozbuga M, Ozturk A, Bayraktar B, Ari Z, Sahinoglu K, Polat G, Gurel I (1999) Surgical anatomy and morphometric analysis of the occipital condyles and foramen magnum. Okajimas Folia Anat Jpn 75(6):329–334
Das S, Suri R, Kapur V (2006) Unusual occipital condyles of the skull: an osteological study with clinical implications. Sao Paulo Med J 124(5):278–279
Dowd GC, Zeiller S, Awasthi D (1999) Far lateral transcondylar approach: dimensional anatomy. Neurosurgery 45(1):95–99. (discussion 99–100)
Katsuta T, Matsushima T, Wen HT, Rhoton AL (2000) Trajectory of the hypoglossal nerve in the hypoglossal canal: significance for the transcondylar approach. Neurol Med Chir (Tokyo) 40:206–210
la Marca F, Zubay G, Morrison T, Karahalios D (2008) Cadaveric study for placement of occipital condyle screws: technique and effects on surrounding anatomic structures. J Neurosurg Spine 9(4):347–353
Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL (1998) Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg 8(3):119–125
Menezes AH (2008) Childs Nerv Syst. Craniocervical developmental anatomy and its implications 24(10):1109–1122
Muthukumar N, Swaminathan R, Venkatesh G, Bhanumathy SP (2005) A morphometric analysis of the foramen magnum region as it relates to the transcondylar approach. Acta Neurochir (Wien) 147(8):889–895
Naderi S, Korman E, Citak G, Guvençer M, Arman C, Senoglu M, Tetik S, Arda MN (2005) Morphometric analysis of human occipital condyle. Clin Neurol Neurosurg 107(3):191–199
Peyton WT, Peterson HO (1942) Congenital deformities in the region of the foramen magnum: basilar impression. Radiology 38:131–144
Schwaber MK, Netterville JL, Maciunas R (1990) Microsurgical anatomy of the lower skullbase—a morphometric analysis. Am J Otol 11(6):401–405
Sen C, Shrivastava R, Anwar S, Traiana A (2010) Lateral transcondylar approach for tumors at the anterior aspect of the craniovertebral junction. Neurosurgery 66(3 Suppl):104–112
Spektor S, Anderson GJ, McMenomey SO, Horgan MA, Kellogg JX, Delashaw JB Jr (2000) Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen magnum and clivus. J Neurosurg 92(5):824–831
Suhardja A, Agur AM, Cusimano MD (2003) Anatomical basis of approaches to foramen magnum and lower clival meningiomas: comparison of retrosigmoid and transcondylar approaches. Neurosurg Focus 14(6):e9
Taitz C (2000) Bony observations of some morphological variations and anomalies of the craniovertebral region. Clin Anat 13(5):354–360
Terasaka S, Day JD, Fukushima T (1999) Extended transbasal approach: anatomy, technique, and indications. Skull Base Surg 9(3):177–184
Tubbs RS, Salter EG, Oakes WJ (2005) Duplication of the occipital condyles. Clin Anat 18(2):92–95 Comment in: Clin Anat. 2005 18(8):646-7; author reply 648
Uribe JS, Ramos E, Vale F (2008) Feasibility of occipital condyle screw placement for occipitocervical fixation: a cadaveric study and description of a novel technique. J Spinal Disord Tech 21(8):540–546
Wanebo JE, Chione MR (2001) Quantitative analysis of the transcondylar approach to the magnum. Neurosurgery 49(4):934–943
Wu A, Zabramski JM, Jittapiromsak P, Wallace RC, Spetzler RF, Preul MC (2010) Quantitative analysis of variants of the far-lateral approach: condylar fossa and transcondylar exposures. Neurosurgery 66(6 Suppl Operative):191–198. (discussion 198)
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Ozer, M.A., Celik, S., Govsa, F. et al. Anatomical determination of a safe entry point for occipital condyle screw using three-dimensional landmarks. Eur Spine J 20, 1510–1517 (2011). https://doi.org/10.1007/s00586-011-1765-y
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DOI: https://doi.org/10.1007/s00586-011-1765-y