Abstract
Purpose
The purpose of our study is to compare cadaver dissections with in vivo diffusion tensor imaging (DTI) to determine the position of the cervicomedullary junction (CMJ) relative to the readily identified anatomic landmarks, namely the obex and olivary bodies (olives), in normal subjects. The information gained from this study would allow further investigation into abnormalities of the CMJ, such as Chiari malformation, without the need for time-intensive tractography studies.
Methods
Six formalin-fixed human cadaver brains were compared with DTI studies in 15 normal controls. Measurements were made from the upper border of the crossing fibers of the pyramidal decussation to both the obex and the inferior margin of the olive.
Results
For the cadaver specimens, the average distance from the inferior border of the olive to the upper border of the decussation measured 3.7 mm (±1.2 mm). The average distance from the obex to the upper decussation was 6.7 mm (±2.1 mm). In the DTI subjects, the inferior olive to the upper decussation averaged 3.4 mm (±0.9 mm). The distance from the obex to the decussation averaged 6.4 mm (±1.3 mm).
Conclusion
The CMJ reliably lies 3.4 mm (±0.9 mm) caudal to the inferior border of the olive and 6.4 mm (±1.3 mm) caudal to the obex. Awareness of this anatomic relationship readily allows recognition of abnormalities of the position of the CMJ with routine imaging.
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Acknowledgments
Data were provided [in part] by the Human Connectome Project, WU-Minn Consortium (Principal Investigators: David Van Essen and Kamil Ugurbil; 1U54MH091657) funded by the 16 NIH Institutes and Centers that support the NIH Blueprint for Neuroscience Research; and by the McDonnell Center for Systems Neuroscience at Washington University.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standard
The submitted study was in compliance with the current laws of the authors’ country. The study was exempted from full IRB review by meeting University of Florida IRB requirements for exemption.
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Middlebrooks, E.H., Yagmurlu, K., Bennett, J.A. et al. Normal relationship of the cervicomedullary junction with the obex and olivary bodies: a comparison of cadaveric dissection and in vivo diffusion tensor imaging. Surg Radiol Anat 37, 493–497 (2015). https://doi.org/10.1007/s00276-014-1387-2
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DOI: https://doi.org/10.1007/s00276-014-1387-2