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The Quantitative Anatomy of the Atlas

Study Design This study is based on direct quantitative caliper measurements of 88 isolated anatomic specimens of the C1 vertebra Objectives The study was undertaken to establish the range and variability of the external dimensions of the atlas and to describe the cortical thicknesses and trabecular distribution of this unlque vertebra. Summary of Background Data Before this study, Francis in 1952 reported the total anterior and posterior diameter of 285 atlas vertebrae. Liu et al reported detailed external dimensions and facet joint surface morphologies on a total of three C1 vertebrae. Methods Measurements were made of overall dimensions, canal diameters, and the dimensions of the anterior and posterior arches of 88 dried human C1 vertebrae. Eight specimens were sectioned in the frontal plane, eight in the sagittal plane, and four in the coronal plane. The anatomy of these sections was documented by radiographic imaging. Cortical thicknesses on the sections were then obtained by direct measurement. Results The canal diameter ranged from 32 mm (SD 2 mm) in the sagittal plane, and 29 mm (SD 2 mm) in the lateral dimension. The mean thickness of the anterior ring was 6 mm (SD 1 mm) and posteriorly was 8 mm (SD 2 mm). Cortical bone was thinnest posteriorly. Conclusions These measurements indicated remarkably constant dimensions for the ring itself, suggesting there may be significant functional restraints on the canal size of this unique vertebra. In contrast, a significant variability was noted in objective measurements of lateral mas height and sagittal plane widths of the entire bone.