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The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries

Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In additio...

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Autores principales: O’Brien, William T, Shen, Peter, Lee, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498315/
https://www.ncbi.nlm.nih.gov/pubmed/26199787
http://dx.doi.org/10.4103/2156-7514.159565
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author O’Brien, William T
Shen, Peter
Lee, Paul
author_facet O’Brien, William T
Shen, Peter
Lee, Paul
author_sort O’Brien, William T
collection PubMed
description Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In addition, congenital anomalies are common in this region, especially those associated with the axis/dens, due to its complexity in terms of development compared to other vertebral levels. The most common congenital variations of the dens include the os odontoideum and a persistent ossiculum terminale. At times, it is necessary to distinguish normal development, developmental variants, and developmental anomalies from traumatic injuries in the setting of acute traumatic injury. Key imaging features are useful to differentiate between traumatic fractures and normal or variant anatomy acutely; however, the radiologist must first have a basic understanding of the spectrum of normal developmental anatomy and its anatomic variations in order to make an accurate assessment. This review article attempts to provide the basic framework required for accurate interpretation of cervical spine imaging with a focus on the dens, specifically covering the normal development and ossification of the dens, common congenital variants and their various imaging appearances, fracture classifications, imaging appearances, and treatment options.
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spelling pubmed-44983152015-07-21 The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries O’Brien, William T Shen, Peter Lee, Paul J Clin Imaging Sci Review Article Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In addition, congenital anomalies are common in this region, especially those associated with the axis/dens, due to its complexity in terms of development compared to other vertebral levels. The most common congenital variations of the dens include the os odontoideum and a persistent ossiculum terminale. At times, it is necessary to distinguish normal development, developmental variants, and developmental anomalies from traumatic injuries in the setting of acute traumatic injury. Key imaging features are useful to differentiate between traumatic fractures and normal or variant anatomy acutely; however, the radiologist must first have a basic understanding of the spectrum of normal developmental anatomy and its anatomic variations in order to make an accurate assessment. This review article attempts to provide the basic framework required for accurate interpretation of cervical spine imaging with a focus on the dens, specifically covering the normal development and ossification of the dens, common congenital variants and their various imaging appearances, fracture classifications, imaging appearances, and treatment options. Medknow Publications & Media Pvt Ltd 2015-06-30 /pmc/articles/PMC4498315/ /pubmed/26199787 http://dx.doi.org/10.4103/2156-7514.159565 Text en Copyright: © 2015 Journal of Clinical Imaging Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Review Article
O’Brien, William T
Shen, Peter
Lee, Paul
The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title_full The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title_fullStr The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title_full_unstemmed The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title_short The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
title_sort dens: normal development, developmental variants and anomalies, and traumatic injuries
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498315/
https://www.ncbi.nlm.nih.gov/pubmed/26199787
http://dx.doi.org/10.4103/2156-7514.159565
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