The Anatomy and Radiology of the Cervical Vertebrae and the Tortuous Vertebral Artery

Abstract

In this combined anatomical and radiological study the authors examine closely the relationship of the vertebral artery to the body, uncinate process and pedicle of cervical vertebra. They provide a detailed and critical examination of the normal and abnormal anatomy of the adjacent vertebra when a tortuous vertebral artery is present. The literature on the phenomenon of tortuous vertebral artery is reviewed and our anatomical and radiological findings are related to previous contributions by other workers. The differences between the radiological appearance of a cervical vertebra with an adjacent tortuous vertebral artery and one affected by neurofibroma are stressed. Some new evidence is provided in support of our suggestion that an indentation or erosion caused by a tortuous vertebral artery may be, at least in some cases, of developmental origin. Our study reveals that while minor indentations of the side of the cervical vertebral body may occur at any level from C2 to C6, the most marked indentations occur with the greatest frequency at C4 and especially on the left side.