Chinese Journal of Tissue Engineering Research ›› 2023, Vol. 27 ›› Issue (20): 3117-3122.doi: 10.12307/2023.148

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Digital morphology of foramen magnum and occipital condyle: an observation based on three-dimensional reconstruction

Wang Jian1, Wang Xing1, 2, Li Kun1, 2, Gao Shang1, Wang Chaoqun3, Zhang Shaojie1, 2, Li Zhijun1, 2   

  1. 1Human Anatomy Teaching and Research Section, 2Digital Medicine Center, 3Imaging Center of Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
  • Received:2021-12-08 Accepted:2022-05-21 Online:2023-07-18 Published:2022-11-18
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Human Anatomy Teaching and Research Section, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Digital Medicine Center, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Zhang Shaojie, Professor, Master’s supervisor, Human Anatomy Teaching and Research Section, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Digital Medicine Center, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
  • About author:Wang Jian, Master candidate, Human Anatomy Teaching and Research Section, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Wang Xing, MD, Human Anatomy Teaching and Research Section, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Digital Medicine Center, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
  • Supported by:
    the National Natural Science Foundation of China, Nos. 81860383 (to LZJ) and 81860382 (to WX); the Natural Science Foundation of Inner Mongolia Autonomous Region, Nos. 2020LH08021 (to LZJ), 2020MS03061 (to WX), and 2019MS08017 (to ZSJ); the College Youth Science and Technology Talent Support Program in Inner Mongolia Autonomous Region, No. NJYT22009 (to WX); Inner Mongolia Autonomous Region Science and Technology Plan Project, No. 2019GG158 (to WX); Inner Mongolia Medical University Key Research Project, No. YKD2021ZD011 (to WX); Medical and Health Science and Technology Plan Project of Inner Mongolia Autonomous Region Health Commission, No. 202201217 (to WX); Inner Mongolia Medical University Youth Fund Project, No. YKD2020QNCX055 (to LK)

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Abstract: BACKGROUND:  Lesions of structures around the ventral side of the brainstem are located in the deep surface of the craniocervical junction, surrounded by important structures. The far lateral approach is the basic surgical method, but sex and lateral differences should be considered in the approach.
OBJECTIVE: To analyze the morphological characteristics of the foramen magnum and occipital condyle by three-dimensional reconstruction measurements, thereby providing anatomical parameters for the far lateral approach to the skull base in clinical practice. 
METHODS: A total of 673 adult patients (448 males and 225 females) with head and neck CT scans were selected. The age ranged from 20 to 87. The length and width of the foramen magnum were measured. The area and index of the foramen magnum were then calculated by formulas. The length and width of the occipital condyle were measured, as well as the angle between the long and sagittal axis of the occipital condyle (O-S angle), the angle between the line connecting the midpoints of anterior and posterior foramen magnum and the line connecting the midpoint of anterior foramen magnum and the intersection of posterior occipital condyle and lateral foramen magnum (F-O angle), and the angle between the line connecting the midpoints of anterior and posterior foramen magnum and the line connecting the midpoint of anterior foramen magnum and the midpoint of the posterior wall of the hypoglossal canal (F-H angle). The sex and lateral differences of each index were analyzed.
RESULTS AND CONCLUSION: There were statistical differences in foramen magnum indexes except between sexes (P > 0.05). The indexes of occipital condyle were significantly higher in males than in females (P < 0.05) except that the left occipital condyle width in males was lower than that in females (P > 0.05). The O-S angle in males was smaller than that in females, and there was a significant difference in the left O-S angle between sexes (P < 0.05). There was no statistical difference between right and left F-H angles. Significant differences were observed in occipital condyle length, occipital condyle width, O-S angle, and F-O angle (P < 0.05). These findings indicate that the parameters of the foramen magnum and occipital condyle were different in sex and on both sides. For the far lateral and transcondylar approaches, the right approach was relatively safe and exposed to a larger range. The length, width, and area of the foramen magnum, the length of the occipital condyle, and O-S angle in males were larger than those in females. Therefore, the sex difference should be considered in the far lateral approach.

Key words: foramen magnum, occipital condyle, computed tomography, three-dimensional reconstruction, far lateral approach

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