• Yılmaz Güvercin, Murat Yaylacı, Ayberk Dizdar, Ayhan Kanat, Uzun YaylacıEcrenEKaradeniz Technical University, Surmene Faculty of Marine Science, 61530 Trabzon, Turkey. Electronic address: ecrenuzun@ktu.edu.tr., Sevil Ay, Ahmet Atilla Abdioğlu, and Ahmet Şen.
• Trabzon Kanuni Training and Research Hospital, Department of Orthopaed & Traumatol, 61000 Trabzon, Turkey. Electronic address: yilmaz.guvercin@erdogan.edu.tr.
• Injury. 2022 Dec 1; 53 (12): 387938863879-3886.

PurposePonticulus posticus (PP) is a variation of the bone bridge that appears in the first cervical vertebra and through which the vertebral artery passes. Odontoid fractures are common spinal bone fractures in older people. This study aims to investigate the effect of neck movements on the odontoid and transverse atlantal ligament (TAL) of people with PP variation from a biomechanical view.MethodC1, C2, and C3 vertebrae of the occipital bone were analyzed using the finite element method (FEM). In this study, solid models were created with the help of normal (N), incomplete (IC), and asymmetric complete (AC) PP tomography images. The necessary elements for the models were assigned, and the material properties were defined for the elements. As boundary conditions, models were fixed from the C3 vertebra, and 74 N loading was applied from the occipital bone. Stress and deformation values in the odontoid and transverse atlantal ligament were obtained by applying 1.8 Nm moment in flexion, extension, bending, and axial rotation directions.ResultsThe stress and deformation values of all three models in odontoid and TAL were obtained, and numerical results were evaluated. In all models, stress and deformation values were obtained in decreasing order in rotation, bending, extension, and flexion movements. The highest stress and strain values were obtained in AC and the lowest values were obtained in N. In all movements of the three models, the stress and deformation values obtained in the TAL were lower than in the odontoid.ConclusionThe greatest stresses and deformations obtained in spines (AC) with PP were found in the odontoid. This may help explain the pathogenesis of odontoid fractures in older people. First, this study explains the mechanism of the formation of neck trauma in people with PP and the need for a more careful evaluation of the direction of impact. Secondly, the study reveals that the rotational motion of the neck independent of PP has more negative effects on the odontoid.Copyright © 2022 Elsevier Ltd. All rights reserved.

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