Atlas occipitalisation associated with other anomalies in a 16th century skeleton from Sardinia (Italy)
Abstract
Archaeological excavations carried out in the plague cemetery of 16th century Alghero (Sardinia) brought to light the skeleton of a male aged 35–45 years, showing anomalies of the atlas. A macroscopic and radiological study has been carried out. The first cervical vertebra is fused with the skull base, resulting in an occipitalisation of the atlas. Absence of the costal element of the left foramen transversarium, resulting in an open anterior foramen transversarium, and posterior arch defect are also observed. The atlanto-occipital junction is a complex structure, susceptible to develop different patterns of congenital defects. These anatomical variations of atlas should be considered in modern clinical practice in order to formulate a correct diagnosis and to conceive an appropriate treatment. Osteoarchaeological cases are important as, beside to ascertain the presence of congenital defects in past populations, allow an in-depth study in dry bones, which can help modern medicine in interpreting anatomical variations. We present an association of congenital anomalies of the atlanto-occipital junction, a condition rarely documented in ancient and modern human skeletal remains.
Keywords: atlas occipitalisationabsence of the costal element of the left foramen transversariumposterior arch defectSardiniamodern age
References
- Al-Motabagani MA, Surendra M. Total occipitalization of the atlas. Anat Sci Int. 2006; 81(3): 173–180.
- Black S, Scheuer L. Occipitalization of the atlas with reference to its embryological development. Int J Osteoarchaeol. 1996; 6: 189–194.
- Buikstra J, Ubelaker D. Standards for Data Collection from Human Skeletal Remains. Arkansas Archaeological Survey Research Series No. 44, Fayetteville, 1994.
- Chauhan R, Khanna J. Absence of costal element of the foramen transversarium of atlas vertebrae. Int J Res Med Sci. 2013; 1(2): 66–68, doi: 10.5455/2320-6012.ijrms20130505.
- Currarino G, Rollins N, Diehl JT. Congenital defects of the posterior arch of the atlas: a report of seven cases including an affected mother and son. AJNR Am J Neuroradiol. 1994; 15(2): 249–254.
- Esses SI. Textbook of spinal disorders. JB Lippincott, Philadelphia, 1995.
- Guenkel S, Schlaepfer S, Gordic S, et al. Incidence and variants of posterior arch defects of the atlas vertebra. Radiol Res Pract. 2013; 2013: 957280.
- Hayes M, Parker G, Ell J, et al. Basilar impression complicating osteogenesis imperfecta type IV: the clinical and neuroradiological findings in four cases. J Neurol Neurosurg Psychiatr. 1999; 66(3): 357–364.
- Kassim NM, Latiff AA, Das S, et al. Atlanto-occipital fusion: an osteological study with clinical implications. Bratisl Lek Listy. 2010; 111(10): 562–565.
- Klimo P, Blumenthal DT, Couldwell WT. Congenital partial aplasia of the posterior arch of the atlas causing myelopathy: case report and review of the literature. Spine. 2003; 28(12): E224–E228.
- Kwon JK, Kim MS, Lee GJ. The incidence and clinical implications of congenital defects of atlantal arch. J Korean Neurosurg Soc. 2009; 46(6): 522–527.
- Milanese M ed. Lo scavo del cimitero di San Michele ad Alghero (fine XIII – inizi XVII secolo). Felici Editore, Pisa, 2010.
- Mudaliar RP, Shetty S, Nanjundaiah K, et al. An osteological study of occipitocervical synostosis: its embryological and clinical significance. J Clin Diagn Res. 2013; 7(9): 1835–1837.
- Rajani S. Is variant anatomy of atlas clinically important? A review. Basic Sci Med. 2014; 3: 1–7.
- Ranade AV, Rai R, Prabhu LV, et al. Atlas assimilation: a case report. Neuroanatomy. 2007; 6: 32–33.
- Saini V, Singh R, Bandopadhyay M, et al. Occipitalization of the atlas: Its occurrence and embryological basis. Int J Anat Variat. 2009; 2: 65–68.
- Senoglu M, Safavi-Abbasi S, Theodore N, et al. The frequency and clinical significance of congenital defects of the posterior and anterior arch of the atlas. J Neurosurg Spine. 2007; 7(4): 399–402.
- Sethi M, Vasudeva N, Mishra S. Study of foramen transversaria of first cervical vertebrae and its variations. OA Anatomy. 2014; 2: 25.
- Sharma M, Singh B, Abhaya A, et al. Occipitalization of atlas with other associated anomalies of skull. Eur J Anat. 2008; 12: 159–167.
- Tun K, Okutan O, Kaptanoglu G, et al. Inverted hypertrophy of occipital condyles associated with atlantooccipital fusion and basilar invagination: a case report. Neuroanatomy. 2004; 3: 43–45.
