Anatomical Features and Clinical Importance of the Vertebral Artery

Ace Dodevski 1  and Dobrila Tosovska-Lazarova 1
  • 1 Institute of Anatomy, Faculty of Medicine, University Ss Cyril and Methodius Skopje, Skopje, Republic of Macedonia

Abstract

The vertebral artery and its branches are target of arteriographic investigations, ultrasound and Doppler visualization, MRI and CT imaging in many contemporary diagnostic procedures. The big horizon of procedures in the interventional and diagnostic radiology, orthopedic and surgery opens new avenues for the study of anatomy and especially variations of the vertebral artery and its branches. The aim of the present report is to give a summary of the vertebral artery anatomy as well as its variations, and to emphasize there clinical importance.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Matula C, Tratting S, Tschabitscher M, Day JD, Koos WT. The course of the prevertebral segment of the vertebral artery: Anatomy and clinical significance. Surg Neurol. 1997;48:125-31.

  • 2. Papazova M, Lazarova D, Zhivadinovic J. Vaskularizacija na mozokot. 1 ed. Skopje: UKIM; 2010.

  • 3. John D. Langdon. Neck. In: Gray’s H. Anatomy. The Anatomical Basis of Clinical Practice. 39 ed. New York: Elsevier, 2005:531-65.

  • 4. Marinkovic S, Milisavljevic M. Arteria vertebralis. In: Marinkovic S, Milisavljevic M, Antunovic V. Arterije mozga i kicmene mozdine: Anatomske i klinicke karakteristike. 1ed. Beograd: Bit inzenjering, 2001:30-9.

  • 5. Bruneau M, Cornelius JF, George B. Anterolateral approach to the V1 segment of the vertebral artery. Neurosurgery. 2006; 58: 215-9.

  • 6. Bhatia K, Ghabriel MN, Henneberg M. Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol. 2005; 64 (3): 217-24.

  • 7. Albayram S, Gailloud P, Wasserman BA. Bilateral arch origin of the vertebral arteries. AJNR Am J Neuroradiol. 2002; 23:455-8.

  • 8. Imre N, Yalcin B, Ozan H. Unusual origin of the left vertebral artery. IJAV. 2010; 3: 80-2.

  • 9. Kubikova E, Osvaldova M, Mizerakova P, Faloudy H, Benuska J. A variable origin of the vertebral artery. Bratisl Lek Listy. 2008; 109 (1):28-30.

  • 10. Nayak SR, Pai MM, Prabhu LV, Sujatha D, Prakash S. Anatomical organization of aortic arch variations in the India: embryological basis and review. J Vasc Bras. 2006; 5 (2): 95-100.

  • 11. Panicker HK, Tarnekar A, Dhawane V, Ghosh SK. Anomalous origin of left vertebral artery - embryological basis and applied aspects - a case report. J Anat Soc India. 2002; 51 (2): 234-5.

  • 12. Poonam SRK, Sharma T. Incidence of anomalous origins of vertebral artery-Anatomical study and clinical significance. Journal of Clinical and Diagnostic Research. 2010; 4:2626-31.

  • 13. Satti SR, Cernigilia A, Koenigsberg RA. Cervical vertebral artery variations: an anatomic study. AJNR Am J Neuroradiol. 2007; 28:976-80.

  • 14. Tratting S, Matula C, Karnel F, et al. Difficulties in examination of the origin of the vertebral artery by duplex and colour-coded Doppler sonography: anatomical considerations. Neuroradiology. 1993; 35:296-9.

  • 15. Zhivadinovik J, Matveeva N, Jovevska S. Anatomic variation in the origin of aortic arch branches. Acta Morpholo. 2009; 6 (2): 15-8.

  • 16. Strub WM, Leach JL, Tomsick TA. Left vertebral artery origin from the thyrocervical trunk: A unique vascular variant. AJNR Am J Neuroradiol. 2006; 27: 1155-6.

  • 17. Buckenham TM, Wright IA. Ultrasound of the extracranial vertebral artery. Brit J Radiol. 2004; 77: 15-20.

  • 18. Lemke AJ, Benndorf G, Liebig T, Felix R. Anomalous origin of the right vertebral artery: review of the literature and case report of the right vertebral artery origin distal to the left subclavian artery. AJNR Am J Neuroradiol. 1999; 20: 1318-21.

  • 19. Komiyama M, Nakajima H, Yamanaka K, Iwai Y. Dual origin of the vertebral artery. Neurol Med Chir. 1999; 39: 932-7.

  • 20. Komiyama M, Morikawa T, Nakajima H, Nishikawa M, Yasui T. High incidance of arterial dissection associated with left vertebral artery of aortic origin. Neurol Med Chir. 2001; 41:8-12.

  • 21. Bernardi L, Dettori P. Angiographic study of a rare anomalous origin of the vertebral artery. Neuroradiology. 1975; 9:43- 7.

  • 22. Wasserman BA, Mikulis DJ, Manzione JV. Origin of the right vertebral artery from the left side of the aortic arch proximal to the origin of the left subclavian artery. AJNR Am J Neuroradiol. 1992;13:355-8.

  • 23. Arnold M, Bousser MG, Fahrni G, et al. Vertebral artery dissection: presenting findings and predictors of outcome. Stroke. 2006;37:2499-503.

  • 24. Shin JH, Suh DC, Choi CG, Lee HK. Vertebral artery dissection: spectrum of imaging findings with emphasis on angiography and correlation with clinical presentation. Radio Graphics. 2000;20:1687-96.

  • 25. Provenzale JM, Morgenlander JC, Gress D. Spontaneous vertebral dissection: clinical, conventional angiographic, CT, and MR findings. J Comput Assist Tomogr. 1996;20:185-93.

  • 26. Pelkonen O, Tikkakoski T, Leinonen S, et al. Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis. Neuroradiology. 2003;45:71-7.

  • 27. Kricun R, Lawrence PL, Winn RH. Tortuous vertebral artery shown by MR and CT. AJNR Am J Neuroradiol. 1992;159:613-5.

  • 28. Lindsey RW, Piepmeier J, Burkus JK. Tortuosity of the vertebral artery: an adventitious finding after cervical trauma. A case report. J Bone Joint Surg Am. 1985;67:806-8.

  • 29. Ono SE, Kawasaki CS, Coelho LOM, Lucaski FF, Neto AC. Widening of intervertebral foramen by tortuous vertebral artery. Arq Neuropsiquiatr. 2009;67(1):115-6.

  • 30. Zimmerman HB, Farreli WJ. Cervical vertebral erosion caused by vertebral artery tortuosity. Am J Roentgenol. 1970;108(4):767-70.

  • 31. Poonam RKS, Rathore NJ. Tortuous vertebral arteriesincidence and clinical implications. J Clin Diagnostic Res. 2011;5(4):780-2.

  • 32. Ranganatha Sastry V, Manjunath KY. The course of the V1 segment of the vertebral artery. Ann Indian Acad Neurol. 2006;9:223-6.

  • 33. Hoon SK, June HL, Gene C, Lee SH. Cervical radiculopathy caused by vertebral artery loop formation: a case report and review of the literature. J Korean Neurosurg. 2010;48:465-8.

  • 34. Oga M, Yuge I, Terada K, Shimizu A, Sugioka Y. Tortuosity of the vertebral artery in patients with cervical spondylotic myelopathy: risk factor for the vertebral artery injury during anterior cervical decompression. Spine. 1996; 21(9):1085-9.

  • 35. Heary RF, Albert TJ, Ludwig SC, et al. Surgical anatomy of the vertebral arteries. Spine. 1996;21:2074-80.

  • 36. Kajimoto BHJ, Addeo RLD, Campos DC, et al. Anatomical study of the vertebral artery path in human lower cervical spine. Acta Ortop Bras. 2007;15(2):84-6.

  • 37. Hong JT, Park DK, Lee MJ, Kim SW, An HS. Anatomical variations of the vertebral artery segment in the lower cervical spine. Spine. 2008;33(22):2422-6.

  • 38. Yamaki K, Saga T, Hirata T, et al. Anatomical study of the vertebral artery in Japanese adults. Anatomical Science International. 2006;81:100-6.

  • 39. Bruneau M, Cornelius JF, Marneffe V, Triffaux M, George B. Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery. 2006;59(1):20-4.

  • 40. Pait TG, Killefer JA, Arnautovic KI. Surgical anatomy of the anterior cervical spine: the disc space, vertebral artery and associated bony structures. Neurosurgery. 1996;39 (4):769-76.

  • 41. Nam KH, Sung JK, Park J, Cho DC. End-to end anastomosis of an unanticipated vertebral artery injury during C2 pedicle screwing. J Korean Neurosurg Soc. 2010;48:363-6.

  • 42. Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M. Vertebral artery injury during anterior decompression of the cervical spine. J Bone Joint Surg. 1993;75(3):410-5.

  • 43. Burke JP, Gerszten PC, Welch WC. Iatrogenic vertebral artery injury during anterior cervical spine surgery. Spine. 2005;508-14.

  • 44. Golfinos JG, Dickman CA, Zabramski JM, Sonntag VK, Spetzler RF. Repair of vertebral artery injury during anterior cervical decompression. Spine.1994;19:2552-6.

  • 45. Lu J, Ebraheim NA. The vertebral artery: surgical anatomy. Orthopedics. 1999;22 (11):1081-5.

OPEN ACCESS

Journal + Issues

Search