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Research on CVJ Anomalies


  1. Chapter 1 – Overview

    1. Anatomy and embriology

    2. Classification

    3. Symptomatology

    4. Imaging

    5. Structure of contents

    6. The Atlas Orthogonal Chiropractic Program

    7. References



  2. Chapter 2 – Embryology of the spine

    1. Developmental phases

      1. Membranous phase

        1. Somites

        2. Resegmentation of the sclerotome



      2. Cartilaginous and osseous phases

        1. Occiput

        2. Atlas

        3. Axis





    2. Vertebrae

      1. Basic anatomy

      2. Development

      3. Figure 13



    3. CVJ

      1. Basic anatomy

        1. Occiput and foramen magnum

        2. Atlas

        3. Axis





    4. Development

      1. Generalizations

      2. Occipital sclerotomes

      3. Proatlas

      4. First cervical sclerotome C1

      5. Second cervical sclerotome C2

      6. Figure 14

      7. Special developmental features of the CVJ



    5. Meneze’s opinion

    6. ANNEX 1: Skeletal maturation and normal development

      1. AP-open mouth upper cervical spine x-ray views

      2. Lateral cervical spine x-rays

      3. Anteroposterior cervical spine x-rays

      4. Review of article: Developmental anatomy of the atlas and axis



    7. Genetic considerations involving CVJ anomalies

      1. Types of CVJ malformations (or anomalies)

      2. Hox Gene

      3. PAX-1 gene



    8. Historical note

    9. Conclusion

    10. References



  3. Chapter 3 – Normal anatomy

    1. Occiput

    2. Atlas

    3. Axis

    4. Occiput and atlas

    5. Atlas and axis

    6. Occiput, atlas and axis

    7. C1-C7

    8. C0-C7

    9. Dry bones

      1. Occiput

      2. Atlas

      3. Axis

      4. Atlas and axis

      5. Occiput, atlas and axis

      6. C1-C7



    10. Soft tissues

    11. Vertebral arteries

    12. References



  4. Chapter 4 – Occiput anomalies

    1. Anatomic considerations

    2. Introduction: basilar invagination, basilar impression and platybasia

    3. Classification

    4. Anterior basilar impression: Basioccipital hypoplasia and platybasia

    5. Posterior basilar impression: Condylar hypoplasia

    6. Combined anterior and posterior BI with opisthion invagination

    7. ANNEX 1 – BI associated syndromes

      1. Chiari Type I (tonsillar ectopia)

      2. Syringomyelia

      3. Occipitalization of the atlas

      4. Torticollis - Short neck – body fusion

      5. Klippel-Feil

      6. Review of articles: Goel [5], [4]

      7. Review of article: Goel [6]



    8. ANNEX 2 – Basic CVJ Craniometry

      1. Introduction

      2. McGregor’s line

      3. Chamberlain’s line

      4. McRae’s line

      5. Klaus index

      6. Boogaard’s line

      7. Boogaard’s angle

      8. Angle of Welcher

      9. The Wackenheim clivus line (or baseline)

      10. Clivus-canal angle

      11. Cervico-medullary angle (CMA)

      12. Goel’s Omega angle

      13. Atlanto-occipital joint axis angle (Schmidt angle)

      14. FischGold’s digastric line (FDGL) and bimastoid line (FBML)

      15. Condyle-C1 interval

      16. Basion-Dental Interval (BDI)

      17. Basion-Axial Interval (BAI)

      18. Atlanto-Dental Interval (ADI)

      19. Posterior ADI (PADI)

      20. Summary



    9. Condylar hyperplasia

      1. Review of article: The Coconut Condyle

      2. Review of article: Inverted hypertrophy of occipital condyles



    10. Opisthion hyperplasia

    11. Hyperplasia of clivus

    12. Bifid Clivus

    13. Occipital Condyle variations

      1. Review of article: Morphometric analysis

      2. Review of article: Anatomical variations of the

      3. Review of article: Unusual occipital condyles

      4. Review of article: Duplication of the occipital condyles

      5. Condylar dysplasia



    14. Foramen Magnum Variations

      1. Localization AP

      2. Localization off center

      3. Dimensions: shape

      4. Dimensions: size

      5. Thickness of the edge



    15. Other variations

    16. References



  5. Chapter 5 – Atlas anomalies

    1. Anatomic considerations

    2. Introduction

    3. Classification

    4. Aplasia/hypoplasia of the anterior arch of the atlas

    5. Aplasia/hypoplasia of the posterior arch of the atlas

    6. 5.1. Review of article: Agenesis of the posterior arch of the atlas

    7. Aplasia/hypoplasia of foramen transversarium in atlas vertebra

      1. Review of article: Bilateral absence of foramen transversarium

      2. Review of article: Case report: Anomalous vertebral artery



    8. Hyperplasia of the anterior arch of the atlas

      1. Review of article: Abnormal bony protuberance of anterior atlas



    9. Combined anterior and posterior atlantal arch defects and lateral mass aplasia

    10. Bifid anterior and posterior arch of the atlas (rachischisis)

    11. Normal variations

      1. Review of articles: [12, 9]



    12. References



  6. Chapter 6 – Odontoid Anomalies

    1. Anatomic considerations

    2. Introduction

    3. Classification

    4. Agenetic/hypoplastic odontoid

    5. Agenesis of the apical segment

    6. Agenesis /hypogenesis) of the basal segment

    7. Os odontoideum

    8. Review of article: Os odontoideum with bipartite atlas and segmental

    9. Ossiculum terminale persistens

    10. Dens bicornis

    11. Bifid dens

    12. Normal variants

    13. References



  7. Chapter 7 – Segmentation anomalies

    1. Anatomic considerations

    2. Introduction: Occipitalization, Occipital vertebrae

      1. First conclusion



    3. Classification

    4. Assimilaton of the atlas

      1. Review of article: Occipitalization of the atlas

      2. Review of article: Total fusion of atlas with occipital bone

      3. Review of article: A case of occipitalization in the human skull

      4. Review of article: Occipitalization of Atlas: A case report

      5. Review of article: Anomalous vertebral artery in

      6. Review of article: The intracranial entrance of the atlantal

      7. Review of article: Total occipitalization of the atlas



    5. Occipital vertebra (hypochordal bow)

      1. Third condyle

      2. Basilar process

        1. Review of article: Precondylar tubercles on the basiocciput



      3. Pre-basioccipital arch

        1. Review of articles: [4], [5]



      4. Isolated Prebasioccipital Arch



    6. Occipital vertebra (skull base)

      1. Basilar transverse fissure

      2. Canalis nervi hypoglossi bipartitus

      3. Labia foraminis magni posteria, incisura marginalis posterior, ossiculum Kerckringi

      4. Processus condylicus posterior

      5. Retromastoid process

      6. Paracondylar and epitransverse process (and other related structures)

        1. Review of article: Paracondylar process, a rare normal.

        2. Review of article: Epitransverse process: a rare





    7. Occipital vertebra (C1)

      1. Ponticulus posterior, lateralis and posterolateralis

      2. Review of article: Dr. Sweat

      3. Review of article: Bilateral Retro Articular ring in Atlas vertebra

      4. Review of article: Abnormal foramina on the posterior arch



    8. Occipital vertebra (C2)

      1. Os avis (dystopic os odontoideum)



    9. Combined Cases

      1. Unfused occipital condyle and clivus

      2. Review of article: Remnants of occipital vertebrae

      3. Review of article: Anomalies of the craniovertebral junction



    10. References



  8. Chapter 8 – Annex

    1. Introduction

    2. Degenerative Joint Disease (DJD); osteoarthrosis

      1. DJD in the CVJ

      2. Review of article: The Craniocervical Junction in Man

      3. Review of article: The Differential Diagnosis of Isolated Ossicles

      4. Review of article: Tubercle at anterior margin

      5. Ossifications and calcifications

      6. DJD in the apophyseal joints

      7. Vertebral arteries



    3. Fusion; synostosis

      1. Block vertebra

      2. Atlanto-axial fusion

      3. Review of article: Fusion of the Atlas Anterior Arch with the Dens

      4. Spine surgery: spinal fusion



    4. Ossicles (and others)

    5. Anomalous articulation

    6. Other anomalies in the CVJ

      1. Atlas

      2. Atlas hypoplasia

      3. Vertebralization of the atlas

      4. Axis

      5. Dens dysplasia



    7. Other anomalies in the cervical spine

      1. Persistent (ununited) secondary ossification centers

      2. Developmental (congenital) spinal stenosis

      3. Congenital spondylolisthesis

      4. Nuclear impressions

      5. Anomalous development of C6

      6. Elongated anterior tubercles of the transverse processes

      7. Cervical rib and elongated C7 transverse process



    8. Normal anatomy simulating fractures

      1. Mach band effect

      2. Review of article: Odontoid lateral mass asymmetry

      3. Notches



    9. Conditions/abnormalities

      1. C2 spondylolysis

      2. Rheumatoid arthritis

      3. Klippel-Feil syndrome

      4. Trisomy 21 (Down syndrome)

      5. Pneumatization



    10. Temporal bone – Styloid process

      1. Anatomy

      2. Development

      3. In adulthood

      4. Normal variations and anomalies

        1. Ossifications and calcifications



      5. DDx

      6. Review of article: Styloid Process and Atlas Transverse

      7. References