Title: Atlanto – Occipital Synostosis - A Detailed Study In South Indian Population

Authors; Dr K. Parthiban, Dr M. Latha, Dr K. Vidulatha, Dr Vinovictor Jesudas

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.14

Abstract

Background: Atlanto – occipital synostosis is a congenital condition in which the atlas the first cervical vertebra is partially or completely fused with the occipital bone.  The condition is also known by other names such as occipitalisation of atlas. Occipito - cervical synostosis, Atlanto- occipital fusion to name a few.  The terminology assimilation of atlas, refers to the complete fusion of the first cervical vertebra to the occipital bone.  It is a rare congenital anomaly with the incidence ranging from 0.14 - 0.75%.  The predilection of the condition is equal for both the sexes.  The condition is of clinical importance because of the compression of the neurovascular structure found along the upper margin of the atlas vertebra thus producing neurovascular deficits which usually produces symptom during the second decade of life.  Iatrogenic atlanto- occipital fusion has been tried as a mode of treatment for the management of atlanto- occipital osteoarthritis.  Hence, the present study aims to throw light on the importance of the incidence, symptomatology, clinical features and embryological basis of the condition.

Materials and Methods: Three hundred and fifty skulls were examined in the Institute of Anatomy, Madurai Medical College, Madurai.  Out of which 3 skulls showed partial occipitalisation of atlas.  The various dimensions were measured using digital vernier caliper.

Results: Three skulls showed partial occipitalisation of atlas, thus showing an incidence of 0.85%

Conclusion: Occipito- cervical fusion has a varied presentation ranging from asymptomatic features, neurovascular deficits to sudden death.  Hence the knowledge of the condition is important in the treatment of patients.

Keywords: Atlanto - occipital synostosis, atlanloaxial joint, osteoarthritis, sclerotome, neurovascular deficit, cervical myelopathy.

References

  1. Sween Walia, Bhawani Shankar Modi, Nidhi Puri, VV Gopichand Patnaik. Occipitalization of Atlas. Int J Anat Res 2014;2(4):781-784.
  2. Yochum TR, Rowe LJ. Essentials of skeletal radiology. Volume 1, 2nd ed. Baltimore, William and Wilkins. 1987:p3.
  3. Nimje DA, Wankhede HA. Atlanto-occipital fusion: A rare anomaly of the craniocervical junction. Edorium J Anat Embryo 2014;1:1–4.
  4. Jayanthi V, Kulkarni R, Kulkarni RN. Atlantooccipital fusion-Report of two cases. Journal of the Anatomical Society of India 2003;52(1).
  5. Mudaliar RP, Shetty S, Nanjundaiah K, Kumar J P, Kc J. An osteological study of occipitocervical synostosis: Its embryological and clinical significance. J Clin Diagn Res 2013 Sep;7(9):1835–7.
  6. singhrajani, Is Variant Anatomy of Atlas Clinically Important A Review. Basic Sciences of Medicine 2014,3(1): 1-7
  7. Sharma M, B. Singh, A. Abhaya1 and H. Kumar Occipitalization of atlas with other associated anomalies of skull Eur J Anat, 12 (3): 159-167 (2008).
  8. Hussain Saheb et al, Occipitalization of Atlas:A Case Report.J Biomed Sci and Res;Vol 2(2),2010,73-7
  9. Inderbir Singh,Text Book Of Human Osteology 2009;pg122
  10. Grays Anatomy 40th edition 2008;pg733.
  11. S. Ranganathan Text Book Of Human Anatomy,6th edition pg617
  12. Inderbir Singh, Human Embryology 9th edition 2012;pg 130.
  13. Carlson, Bruce M, Human Embryology And Developmental Biology, 4th edition      pg   140.

Corresponding Author

Dr M. Latha

Assistant Professor, Institute of Anatomy, Madurai Medical College, Madurai. TamilNadu, India

Conduct No: 9791774792, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.