CT imaging study of anatomical parameters related to occipital condyle in the far lateral approach
Hu Haijian, Diao Yuling, Jin Baozhe
Department of Neurosurgery, the First Affiliated Hospital of Xinxiang Medical University,Henan Key Laboratory of Neural Rehabilitation, Weihui 453100, China
Abstract：Objective To explore the CT image measurement of the anatomical parameters of the occipital condyle in normal adults, and to provide an anatomical basis for the treatment of the occipital condyle in the far lateral approach.Methods The imaging data of 335 normal adults with head and neck CTA in the imaging database of the First Affiliated Hospital of Xinxiang Medical University from September 2018 to March 2019 were analyzed retrospectively. After three-dimensional reconstruction of occipital condyle with Mimics software, the positioning points of the midpoint of anterior edge of foramen magnum (A), the midpoint of posterior edge of foramen magnum (B), the posterior edge of occipital condyle and posterior edge of foramen magnum (C) and the midpoint of posterior edge of internal orifice of hypoglossal nerve canal (D) were marked. The ∠α that was between the line connecting point A and point B and the line connecting point A and point C, the ∠β between the line connecting point A and point B and the line connecting point A and point D and the length between point C and point D and the anteroposterior diameter length of occipital condyle were measured. The difference between ∠β and ∠α was calculated. The paired sample t-test was used to compare the differences of the above measurements between different sides.Results Total measurements on both sides of 335 normal adults, ∠α was 32.49°-52.18° (42.06°±3.25°), ∠β was 43.62°-73.48° (58.51°±5.37°), the difference between ∠β and ∠α was 7.42°-30.10° (16.45°±4.07°); the length of CD was 6.18-13.08 (8.94±1.33)mm, the anteroposterior diameter length of occipital condyle was 16.12-27.71 (21.57±2.17)mm. ∠α was 42.12° ± 2.88° on the left and 42.00° ± 3.59° on the right. ∠β was 59.37° ± 5.24° on the left, and 57.66° ± 5.39° on the right. The difference between ∠β and ∠α was 17.24° ± 4.13° on the left, and 15.66° ± 3.87° on the right. The length of CD was (9.14 ± 1.39) mm on the left side and (8.73 ± 1.23) mm on the right side. The anteroposterior diameter length of occipital condyle was (21.59 ± 2.28) mm on the left side and (21.55 ± 2.08) mm on the right side. Comparison between different sides: the measured values of ∠β,the difference between∠β and∠α, the length of CD on the left side were higher than those on the right side, and the differences were statistically significant (t=4.402, 5.971, 4.199, all P values＜0.05). There was no significant difference between the∠α and the anteroposterior diameter length of occipital condyle (all P values＞0.05).Conclusions There are differences in anatomical measurement data of normal occipital CT images between different sides. The bone from the posterior edge of the occipital condyle to the internal orifice of the hypoglossal nerve canal is removed in the far lateral approach, and the surgical field and enlarged visual angle on the left side are larger than those on the right side. For the ventral median lesion of occipital foramen, it is suggested that craniotomy from the left can obtain a larger exposure range.
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Hu Haijian, Diao Yuling, Jin Baozhe. CT imaging study of anatomical parameters related to occipital condyle in the far lateral approach. Chinese Journal of Anatomy and Clinics, 2020, 25(3): 227-231.
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2020, Vol. 25 
