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The relationship between density variations of transverse ligament tubercles on multidetector computed tomography (MDCT) and age, gender, or laterality in a large cohort

  • Qinhua Luan
  • Yongguang BanEmail author
  • Kai Liu
  • Bo Sun
  • Ximing Wang
  • Xiangtao Lin
Original Article
  • 17 Downloads

Abstract

Background

Transverse ligament tubercles are unique structures that maintain the stability of the upper cervical spine. However, the density variations of tubercles in different clinical contexts or populations have not been carefully studied through multidetector computed tomography (MDCT).

Purpose

This study aimed to evaluate the relationship between density variations in the transverse ligament tubercles, as measured through multidetector computed tomography (MDCT), with age, gender, or laterality.

Methods

A cohort of 339 Chinese patients that underwent MDCT in the head or neck were recruited. The patients were divided into eight age groups. The densities of the bilateral transverse ligament tubercles were classified through MDCT, and the potential relationship between the density of the tubercles and the age, gender, or laterality was analyzed.

Results

Based on MDCT findings, four different density types of tubercles were identified (type 0–III). Our data suggest that the density of tubercles increased with age (χ2 = 637.7, p < 0.05). However, the density of tubercles did not correlate with laterality (male: t = 0.217, p > 0.05, female: t = 1.448, p > 0.05) or gender (χ2 = 5.706, p > 0.05).

Conclusions

The density of the transverse ligament tubercles, as measured through MDCT, shows a stereotyped dynamic pattern, i.e., it apparently increases with age, but neither gender nor laterality significantly contribute to these changes.

Keywords

Spine Anatomic variation Transverse ligament tubercles Density Multidetector computed tomography (MDCT) 

Notes

Author contributions

LQ, BY, and LK: project development, data collection, data analysis, and manuscript writing. SB and BY: data analysis and manuscript editing. WX and LX: project development and data analysis.

Funding

This study was funded by Shandong Provincial Medical and Health Science and Technology Development program (Nos. 2018WS226, 2016WS0531, 2015WS0177, 2015WS0182), National Natural Science Foundation of China (No. 81201144), Postdoctoral Science Foundation of China(No. 2015M582098).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Arslan M, Acar HI, Comert A (2017) Cervical extraforaminal ligaments: an anatomical study. Surg Radiol Anat 12:1377–1383CrossRefGoogle Scholar
  2. 2.
    Ban Y, Luan Q, Liu K et al (2016) Variation of bilateral transverse ligament tubercles with age and gender in a large series of subjects on multidetector computed tomography. Acta Radiol 57:721–725CrossRefGoogle Scholar
  3. 3.
    Burguet JL, Sick H, Dirheimer Y et al (1985) CT of the main ligament of the cervico-occipital hinge. Neuroradiology 27:112–118CrossRefGoogle Scholar
  4. 4.
    Debernardi A, D’Aliberti G, Talamonti G et al (2013) Traumatic (type II) odontoid fracture with transverse atlantal ligament injury: a controversial event. World Neurosurg 79:779–783CrossRefGoogle Scholar
  5. 5.
    Diaz JJ Jr, Aulino JM, Collier B et al (2005) The early work-up for isolated ligamentous injury of the cervical spine: does computed tomography scan have a role? J Trauma 59:897–903CrossRefGoogle Scholar
  6. 6.
    Dickman CA, Mamourian A, Sonntag VK et al (1991) Magnetic resonance imaging of the transverse atlantal ligament for the evaluation of atlantal instability. J Neurosurg 75:221–227CrossRefGoogle Scholar
  7. 7.
    Fishman EK, Lawler LP (2004) CT angiography: principles, techniques and study optimization using 16-slice multidetector CT with isotropic datasets and 3D volume visualization. Crit Rev Comput Tomogr 45:355–388CrossRefGoogle Scholar
  8. 8.
    Hogan GJ, Mirvis SE, Shanmuganathan K et al (2005) Exclusion of unstable cervical spine injury in obtunded patients with blunt trauma: is MR imaging needed when multi-detector row CT findings are normal? Radiology 237:106–113CrossRefGoogle Scholar
  9. 9.
    Liu K, Lü Y, Cheng D et al (2014) The prevalence of osteoarthritis of the atlanto-odontoid joint in adults using multidetector computed tomography. Acta Radiol 55:95–100CrossRefGoogle Scholar
  10. 10.
    Liu K, Xie F, Wang D et al (2015) Reference ranges for atlantodental interval in adults and its variation with age and gender in a large series of subjects on multidetector computed tomography. Acta Radiol 56:465–470CrossRefGoogle Scholar
  11. 11.
    Mesfar W, Moglo K (2013) Effect of the transverse ligament rupture on the biomechanics of the cervical spine under a compressive loading. Clin Biomech (Bristol, Avon) 28:846–852CrossRefGoogle Scholar
  12. 12.
    Nonthasaen P, Nasu H, Kagawa E et al (2018) A morphological comparison of the extraforaminal ligament between the cervical and thoracic regions. Surg Radiol Anat 5:571–580CrossRefGoogle Scholar
  13. 13.
    O’Rahilly R, Müller F, Meyer DB (1983) The human vertebral column at the end of the embryonic period proper. 2. The occipitocervical region. J Anat 136:181–195Google Scholar
  14. 14.
    Piatt JH Jr, Grissom LE (2011) Developmental anatomy of the atlas and axis in childhood by computed tomography. J Neurosurg Pediatr 8:235–243CrossRefGoogle Scholar
  15. 15.
    Radcliff KE, Ben-Galim P, Dreiangel N et al (2010) Comprehensive computed tomography assessment of the upper cervical anatomy: what is normal? Spine J 10:219–229CrossRefGoogle Scholar
  16. 16.
    Tsukagoshi S, Ota T, Fujii M et al (2007) Improvement of spatial resolution in the longitudinal direction for isotropic imaging in helical CT. Phys Med Biol 52:791–801CrossRefGoogle Scholar
  17. 17.
    Tubbs RS, Wellons JC 3rd, Banks J et al (2002) Quantitative anatomy of the transverse ligament tubercls. J Neurosurg 97:343–345Google Scholar
  18. 18.
    Yüksel KZ, Yüksel M, Gonzalez LF et al (2008) Occipitocervical vertical distraction injuries: anatomical biomechanical, and 3-tesla magnetic resonance imaging investigation. Spine (Phila Pa 1976) 33:2066–2073CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Shandong Provincial Hospital Affiliated to Shandong UniversityJinanPeople’s Republic of China
  2. 2.Shandong Medical Imaging Research Institute Affiliated to Shandong UniversityJinanPeople’s Republic of China

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