Commentary on: “Vertebral Artery Anomalies at the Craniovertebral Junction: A Case Report and Review of the Literature”

摘要

The authors report a case of an unstable C1 fracture with magnetic resonance imaging demonstrating rupture of the transverse ligament. Posterior vertebral artery anomaly in the form of a right persistent first intersegmental artery was identified preoperatively in the region of the right posterior C1–C2 lateral mass interval. The surgical plan was altered to avoid the anomalous vertebral artery and the patient was successfully managed with an uncomplicated occiput to C3 instrumentation and fusion procedure. The literature review includes a discussion of the work by Uchino et al who have reported a persistent first intersegmental artery in up to 3.2% of normal subjects and an overall prevalence of craniovertebral junction vertebral artery anomalies of 5%.1