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Bilateral arcuate foramen associated with partial defect of the posterior arch of the atlas in a medieval skeleton: case report and review of the literature. Looking backward to go forward

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Abstract

Purpose

We observed a complex atlas (C1) dysmorphism in a human medieval skeleton dug up from the sixth to the seventh century necropolis located in the north-eastern Italy. We analyzed such a dysmorphism in the light of pertinent literature and discussed the functional and clinical implications related to this type of C1 structural malformation.

Methods

Macroscopical and CT-SCAN examinations of the atlas were carried out.

Results

Bone findings consisted of partial aplasia of the posterior arch of the C1 accompanied by a bilateral arcuate foramen. In addition, the spinous processes of C7 and T1 were found to be bifid.

Conclusions

Although such abnormalities are supposed to be clinically inconspicuous, yet they may become challenging or even dangerous in the context of trauma. They may even complicate specific diagnostic or surgical procedures. In addition, they may cause a great number of symptoms, ranging from headache and neck pain to loss of postural muscle tone and consciousness, due to the close and complex relationship of bone structures with nerves, blood vessels, muscles, and ligaments. As a result, radiologists, clinicians, surgeons, and chiropractors should consider in their clinical reasoning the possibility that atlas dysmorphisms may occur.

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Acknowledgments

This work was supported by local funds from Ministero dell’Istruzione, dell’Università e della Ricerca, Rome, to the Department of Medical and Morphological Research, Anatomy Section, University of Udine. We are grateful to dott. Serena Vitri, Soprintendenza per i Beni Archeologici del Friuli Venezia Giulia, for access to skeletal material and to dott. Francesco Toso for radiological images.

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Authors and Affiliations

  1. Department of Medical and Morphological Research, Section of Anatomy, University of Udine Medical School, Piazzale Kolbe 3, 33100, Udine, Italy

    Luciana Travan, Paola Saccheri & Enrico Crivellato

  2. Department of Clinical, Morphological, and Technological Sciences, University of Trieste Medical School, Strada di Fiume n. 447, 34100, Trieste, Italy

    Gastone Sabbadini

Authors
  1. Luciana Travan
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  2. Paola Saccheri
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  3. Gastone Sabbadini
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  4. Enrico Crivellato
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Correspondence to Enrico Crivellato.

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Travan, L., Saccheri, P., Sabbadini, G. et al. Bilateral arcuate foramen associated with partial defect of the posterior arch of the atlas in a medieval skeleton: case report and review of the literature. Looking backward to go forward. Surg Radiol Anat 33, 495–500 (2011). https://doi.org/10.1007/s00276-010-0760-z

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  • DOI: https://doi.org/10.1007/s00276-010-0760-z

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