![]() Therefore, correct measurements are essential as such findings can influence presurgical planning.Īnatomy Chiari malformation I Odontoid Odontoid retroflexion Posterior inclination Retroflexed dens Retroverted dens.Ĭopyright © 2020 Elsevier Inc. 12, in whom there had been a craniovertebral fusion ten years previously, had a fully developed odontoid process. ![]() ![]() Research has demonstrated that high degree of dens angulation can result in significant anterior brain stem compression with the need for both anterior and posterior decompression in patients with symptomatic CM1.Ī greater degree of dens angulation can lead to neurologic symptoms secondary to spinomedullary compression. Key words for our search included retroverted dens retroflexed dens odontoid retroflexion posterior inclination and tilted dens.Ī retroverted dens is most commonly found in the pediatric population in relation to CM1. Using standard search engines, we performed a literature review of anatomical, radiologic, and clinical studies as well as pathologic and surgical considerations related to the retroverted dens. as for typical vertebrae but has two extra primary ossification centers for the dens (odontoid process) The primary ossification centers first appear at. one for each side of the posterior arch (two in total) C2 (axis): five primary ossification centers in total. However, this finding can have a clinical impact, especially in patients with Chiari malformation type I (CM1), as it can have consequences for further treatment. C1 (atlas): three primary ossification centers in total. Little attention has been given to the retroverted dens within the existing medical literature. George's, Grenada Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA. 7 Department of Anatomical Sciences, St.6 Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA. Basilar invagination is term used for developmental anomalies of craniovertebral junction where odontoid has abnormal relationship to foramen magnum (prolapse).Electronic address: 5 Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA. 4 Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.3 Tulane University & Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, New Orleans, Louisiana, USA.2 Department of Anatomical Sciences, St. ![]() 1 Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany. ![]()
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