MyMedR

Fulltext Ponticulus posticus of atlas vertebrae: an incidental finding in Malaysian orthodontic patients

Donald PM, Nagraj SK, Pallivathukkal RG, Ismail ARB

BMJ Case Rep, 2017 Aug 21;2017.

PMID: 28827299 DOI: 10.1136/bcr-2017-220851

Matched MeSH terms: Cervical Atlas/abnormalities

Fulltext What the mind does not know, the eyes do not see: a rare congenital fusion of the odontoid process to the atlantal hemiarch

Sureisen M, Achannan R, Chong KC, Wong CC

BMJ Case Rep, 2015 Oct 27;2015.

PMID: 26508120 DOI: 10.1136/bcr-2015-212748

Congenital spinal fusion of an odontoid process to an atlantal hemiarch is very rare. The unfamiliarity of the medical fraternity with this congenital malformation can easily be mistaken for an acute fracture, chronic infection or inflammatory disease. We present our experience of managing an adult who presented with neck pain after a motor vehicle accident. Radiological investigation revealed congenital fusion of the odontoid process to the atlantal hemiarch. The prevalence, embryology and clinical significance of this anomaly are discussed. As the natural progression of this anomaly is not well documented, we suggest periodic follow-up to monitor the progression of degenerative changes and instability of the occipitoatlantal junction.

Matched MeSH terms: Cervical Atlas/abnormalities*; Cervical Atlas/embryology

Signatures of gene expression, DNA methylation and microRNAs of hepatocellular carcinoma with vascular invasion

Sulaiman SA, Abu N, Ab-Mutalib NS, Low TY, Jamal R

Future Oncol, 2019 Aug;15(22):2603-2617.

PMID: 31339048 DOI: 10.2217/fon-2018-0909

Aim: Micro and macro vascular invasion (VI) are known as independent predictors of tumor recurrence and poor survival after surgical treatment of hepatocellular carcinoma (HCC). Here, we aimed to re-analyze The Cancer Genome Atlas of liver hepatocellular carcinoma datasets to identify the VI-expression signatures. Materials & methods: We filtered The Cancer Genome Atlas liver hepatocellular carcinoma (LIHC) datasets into three groups: no VI (NVI = 198); micro VI (MIVI = 89) and macro VI (MAVI = 16). We performed differential gene expression, methylation and microRNA analyses. Results & conclusion: We identified 12 differentially expressed genes and 55 differentially methylated genes in MAVI compared with no VI. The GPD1L gene appeared in all of the comparative analyses. Higher GPD1L expression was associated with VI and poor outcomes in the HCC patients.

Matched MeSH terms: Cervical Atlas

Fulltext Congenital atlanto-axial dislocation

Tan CT, Loh TG, Balasubramaniam P

Med J Malaysia, 1981 Dec;36(4):230-3.

PMID: 7334959

Matched MeSH terms: Cervical Atlas/injuries*

Fulltext Congenital Absence of the Posterior Arch of the Atlas â€“ A Strange but Benign Anomaly

Tan, E.C., Soon, H.C., Kevin, M., Se To, B.C.

Malays Orthop J, 2007;1(2):30-32.

MyJurnal

Congenital partial aplasia of the atlas with a posterior arch remnant is rare. It may be found as an incidental radiological finding or patients can present with neurological signs and symptoms after head or neck trauma. A 36-year-old female presented with a 3-day history of right sided neck pain radiating down the right arm. Radiographs of the cervical spine showed a radiolucent area in the region of the posterior arch of the atlas. Computed tomography subsequently revealed partial absence of the posterior arch of the atlas with a defect at the anterior ring. Her clinical condition subsequently improved with rest, analgesia and physiotherapy. This case report illustrates a situation where congenital defect of the posterior arch of the atlas was revealed in a patient with neck pain. Awareness of the existence of this condition will help clinicians avoid misdiagnosis and excessive investigations.

Matched MeSH terms: Cervical Atlas

Is C1 lateral mass screw placement safe for the Chinese, Indians, and Malays? An analysis of 180 computed tomography scans

Lee CK, Tan TS, Chan C, Kwan MK

J Orthop Surg (Hong Kong), 2017 01;25(1):2309499017692683.

PMID: 28211302 DOI: 10.1177/2309499017692683

INTRODUCTION: C1 lateral mass (C1LM) screw is a common procedure in spine surgery. However, related studies are lacking in Asia. We aim to determine the safety of C1LM screw for the Chinese, Indians, and Malays.

METHODS: Three-dimensional computed tomographies of 180 subjects (60 from each ethnic) were analyzed. The length and angulations of C1LM screw and the location of internal carotid artery (ICA) in relation to C1LM were assessed and classified according to the classification by Murakami et al. The incidence of ponticulus posticus (PP) was determined and the differences among the population of these three ethnics were recorded.

RESULTS: The average base length was 8.5 ± 1.4 mm. The lengths within the lateral mass were between 14.7 ± 1.6 mm and 21.7 ± 2.3 mm. The prevalence of PP was 8.3%. 55.3% (199) of ICA were located in zone 0, 38.3% (138) in zone 1-1, 6.4% (23) in zone 1-2, and none in zone 1-3 and zone 2. The average angulation from the entry point to the ICA was 8.5° ± 6.4° laterally. The mean distance of ICA from C1 anterior cortex was 3.7 ± 1.7 mm (range: 0.6∼11.3). There was no difference in distribution of ICA in zone 1 among the three population (Chinese-47%, Indians-61%, and Malays-53%; p > 0.05).

CONCLUSIONS: No ICA is located medial to the entry point of C1LM screw. If bicortical purchase of C1LM screw is needed, screw protrusion of less than 3 mm or medially angulated is safe for ICA. The incidence of PP is 8.3% with higher prevalence among the Indian population.

Matched MeSH terms: Cervical Atlas/surgery*

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