World Neurosurg
-
Review Meta Analysis
The prevalence of the ponticulus posticus (arcuate foramen) and its importance in the Goel-Harms procedure: meta-analysis and review of the literature.
We reviewed published radiographic and cadaver series describing the incidence of the anatomical anomaly ponticulus posticus and discuss its relevance to C1 lateral mass screw (C1LMS) insertion. ⋯ The atlantal anomaly ponticulus posticus is not rare, occurring in 16.7% of patients in radiographic and cadaver studies. This anomaly may give the false impression that the posterior arch of the atlas is of adequate size to accommodate a C1LMS and may lead to inadvertent vertebral artery injury. Careful assessment via preoperative multiplanar computed tomographic imaging should be performed before consideration of C1LMS implantation.