Morphologic Changes in the Vertebral Artery Subsequent to Cervical Spine Degeneration and Aging: Analyses by Computed Tomography Angiography Using Multiplanar and 3-Dimensional Reconstructions.
OBJECTIVE
To identify the morphologic changes in the vertebral artery (VA) subsequent to cervical spine degeneration and aging and to investigate the risk factors for iatrogenic VA injury or occlusion.


METHODS
Eighty-eight consecutive patients (176 bilateral VAs) were retrospectively analyzed using radiographs, computed tomography, and computed tomography angiography images. The Kellgren and Lawrence (KL) score and its modified subscores were used to grade the severity of degenerative changes in the cervical spine. VA tortuosity widths and diameters were measured between the C2 and C6 transverse foramens. The outcome measures were statistically analyzed for difference, correlation, and explanatory variable. The level with a high prevalence of VA stenosis was also evaluated.


RESULTS
There were significant positive correlations between the KL score and VA tortuosity width, and between age and VA tortuosity width. Osteophyte formation in the facet joint was the predominant explanatory variable for medial deviation of the VA. Significant positive correlations were evident between the dominant VA diameter and KL score or age. VA stenosis occurred at C3/C4 (24.5%) with the highest prevalence and it was caused by uncovertebral joint osteophytes (52.0%) with the highest incidence.


CONCLUSIONS
The present study provides important evidence for decisions of surgical strategy and for avoiding catastrophic VA injury or occlusion in cervical spine surgeries.
['Ohnishi|Takashi|T|', 'Suda|Kota|K|', 'Komatsu|Miki|M|', 'Harmon|Satoko Matsumoto|SM|', 'Watanabe|Takamasa|T|', 'Asukai|Mitsuru|M|', 'Kadoya|Ken|K|', 'Takahata|Masahiko|M|', 'Iwasaki|Norimasa|N|', 'Minami|Akio|A|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000375:Aging D002574:Cervical Vertebrae D000072226:Computed Tomography Angiography D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007090:Image Interpretation, Computer-Assisted D021621:Imaging, Three-Dimensional D055959:Intervertebral Disc Degeneration D008297:Male D008875:Middle Aged D012189:Retrospective Studies D014711:Vertebral Artery D055815:Young Adult
Vertebral artery Cervical spine Degeneration Aging Occlusion Tortuosity Stenosis