Objective To analyze the three-dimensional imaging characteristics of the linear and angular parameters of the C2 pedicle in patients with dominant vertebral artery. Methods The cervical computed tomography angiography (CTA) imaging data of 186 patients from March 2022 to February 2023 were retrospectively reviewed. Vertebral artery dominance (VAD) was defined as a difference in the cross-sectional diameter of the bilateral vertebral arteries at the C2 transverse foramen greater than 0.8 mm. Patients with VAD were classified as the VAD group, and those without VAD were the normal control group. Multi-planar reconstruction (MPR) was performed using the RadiAnt DICOM Viewer software. The pedicle outer width (POW), pedicle transverse angle (PTA), and isthmic-pedicle sagittal angle (IPSA) of C2 were measured. The proportion of narrow pedicles (POW<4.0 mm) in both groups was recorded. The influence of VAD on the morphology of the C2 pedicle was analyzed. Results Among the 186 patients, 49.5% (92/186) were accompanied by VAD, with the left side accounting for 67.4% (62/92); the incidence of VAD in females was higher than that in males (P<0.05). Intra-group comparison showed that in the VAD group, the POW (4.2± 1.3) mm and IPSA (32.6±4.9)° on the dominant side of C2 were smaller than those on the non-dominant side [(5.8±1.4) mm and （36.4±5.5）°, P<0.001], but the PTA (36.7±6.4)° on the dominant side was greater than that on the non-dominant side [(30.6±7.1)°, P<0.001]. There was no statistical difference in POW, PTA and IPSA on the left and right sides of C2 in the control group (P>0.05). The overall proportion of narrow pedicles in the VAD group (26.6%) was higher than that in the control group (10.6%, P<0.001); the proportion of narrow pedicles on the dominant side in the VAD group was higher than that on the non-dominant side (44.6% vs. 8.7%, P<0.001). Multivariate Logistic regression analysis showed that VAD was an independent risk factor for narrow pedicles (Odds Ratio [OR]: 7.076, 95% CI: 3.176-15.764, P<0.001). Conclusions There is a correlation between VAD and the morphological changes of the C2 pedicle. The pedicle on the dominant side is thinner, has a greater medial inclination and a smaller caudal inclination. The above morphological characteristics have guiding significance for the safe screw placement of the C2 pedicle.
Key words
Dominant vertebral artery; /
/
Axis pedicle /
Imaging observation; /
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Narrowed pedicle /
Association
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