Introduction- With the growing prevalence of cranio-vertebral anomalies in northern part of India a study was conducted to know the burden of cranio-vertebral anomalies, its associated clinical spectrum and radiological features in our geographical region.
Methodology- A cross-sectional study was conducted in north eastern parts of Uttar Pradesh at Sir sunderlal hospital, Banaras Hindu University, Varanasi. Patients with clinical features like short neck, low hair line, restricted neck movement associated with signs of high cervical cord myelopathy were included in the study. These patients were then evaluated by x-ray cervical spine along with magnetic resonance imaging (MRI) of cervical spine to look for bony and soft tissue anomalies.
Result- Forty three (43) patients were enrolled in study and all of them had some bony anomalies. Out of 43 patients, 42 patients had atlantoaxial dislocation (98%), 26 patients had platybasia (60%), 22 patients had basilar invagination (51%). Among soft tissue anomalies 10 patients had arnold -chiari malformation (23%) and 9 had syringomyelia.(21%)
Conclusion- Cranio-vertebral anomalies should be considered in patients presenting with short neck and restriction of neck motion along with symptoms and signs of high cervical cord myelopathy. The diagnosis can be easily made on plain radiographs in lateral and antero-posterior view of cervical spine and if a question of instability arises, lateral views in the flexed and extended position are obtained to gain an understanding of the biomechanics. Magnetic resonance imaging is the ideal tool in diagnosing and defining all bony anomalies and soft tissue anomalies except Atlanto-axial instability which is better evaluated on plain dynamic radiographs.
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