Radiological and anatomical evaluation of the craniovertebral junction

Aim: Congenital and acquired anomalies seen in the craniovertebral junction (CVJ) can cause instability and affect neurovascular structures. This study aimed to determine the normal values of craniometric parameters obtained from computed tomography (CT) images and to reveal the difference between the sexes. Material and method: Between January 2022 and December 2022, the CT images of 500 patients (250 women and 250 men aged 25-40 years) with cranial CT images were retrospectively evaluated. Atlanto-dental interval (ADI), Posterior atlanto-dental interval (PADI), McGregor Line, Chamberlain Line, McRae Line, Wachenheim Clivus Canal Angle (Craniovertebral Angle), Sphenoid angle, Welcher Basal Angle, Basion Axial Space, Basion Dental Space and Craniocervical Inclination Angle craniometric measurements were made from the CT images and comparisons were made between genders. Results: Mean ADI was 1.45±0.01 mm, mean PADI was 19.35±0.09 mm, mean McGregor line was 79.78±0.21 mm, mean Chamberlain line was 76.95±1.21 mm and mean McRae line was 36.27±0.12 mm, mean basion dental interval was 5.32±0.06 mm and mean basion axial interval was 7.13±0.07 mm. Mean Clivus canal angle was 154.65±0.45o, mean Sphenoid angle was 121.15±0.39o, mean Welcher basal angle was 130.02±0.28o and mean craniocervical tilt angle was 123.94±0.44o. While the mean values of ADI, Clivus canal angle and Welcher basal angle of women were significantly higher than men, the mean values of PADI, McGregor line, Chamberlain line, McRae line, Basion axial interval and Craniocervical tilt angle of men were significantly higher than women. Sphenoid angle and Bazion dental parameters were not significantly different between genders. Conclusion: When the literature is examined, the differences between these measurements are striking, so we think that our results will contribute to filling the gap in this area by obtaining data from different societies.