Neurol India. 2025 Jul 1;73(4):716-720. doi: 10.4103/neurol-india.Neurol-India-D-24-00524. Epub 2025 Jul 24.
ABSTRACT
BACKGROUND: The craniovertebral junction (CVJ) is associated with congenital anomalies such as atlanto-axial dislocation (AAD) and basilar invagination (BI). The role of bony anatomy in these pathologies is well studied. The posterior atlanto-occipital membrane complex (PAOMc) (equivalent of ligamentum flavum) is often seen to be forming a tight band-like constricting structure in the CVJ anomalies and has been less studied.
OBJECTIVES: This study aimed to compare the histological characteristics of PAOMc in CVJ anomaly patients with those in patients undergoing surgery for posterior fossa tumors (controls).
METHODS: This observational study included 41 patients, divided into two groups: 22 with congenital CVJ anomalies undergoing C1-C2/occipitocervical fixation and 19 undergoing surgeries for posterior fossa tumors. PAOMc samples from both groups were analyzed using hematoxylin and eosin, Mason Trichrome, Alcian Blue, and Van Gieson stains. Immunohistochemistry for CD34 and CD68 markers was performed. Histological parameters were graded and compared using appropriate statistical test.
RESULTS: Both the groups were comparable with respect to age and gender. Histological and immunohistochemistry comparison revealed no significant differences in all the evaluated parameters between the PAOMc of patients with congenital CVJ anomalies and those of the control group (p- value > 0.05).
CONCLUSION: The present study is the first study to study the role of PAOMc in congenital CVJ anomalies. The findings indicate that PAOMc may not play a significant role in the pathology of these anomalies, contrasting with the ligamentum flavum in other spinal regions.
PMID:40705287 | DOI:10.4103/neurol-india.Neurol-India-D-24-00524
