Osseous Variants of the Cervical Spine with Potential Pathological Significance: Possible Evidence of Vertebrobasilar Insufficiency in a Skeletal Sample from the Post-Classical Cemetery of Corfinio (12th–15th Centuries CE, L’Aquila, Italy)
Abstract
:1. Introduction
Cervical Spine Anatomy Overview
2. Materials and Methods
2.1. Original and Study Skeletal Samples
2.2. Archaeological Background of the Funerary Area
2.3. Analytical and Methodological Procedures
2.3.1. Morphological Data Collection
2.3.2. Metric Data Collection
2.3.3. Statistical Analysis
3. Results
3.1. Osseus Variations of FT
3.1.1. Variations in Number
3.1.2. Variations in Size
Normal FT
3.1.3. Variations in Shape
Normal FT
3.2. Osseous Variations of Vertebra C1
3.2.1. Ponticulus Posticus (PP)
3.2.2. Ponticulus Lateralis (PL)
3.2.3. Retrotransverse Foramen (RTF)
4. Discussion
4.1. Osseous Variations of FT
4.1.1. Variations in Number
4.1.2. Variations in Size
Normal FT
Complete Double FT
4.1.3. Variations in Shape
Normal FT
4.2. Osseous Variations of Vertebra C1
4.2.1. Ponticulus Posticus (PP) and Ponticulus Lateralis (PL)
4.2.2. Retrotransverse Foramen
5. Concluding Remarks and Suggestions for Further Research
- The prevalence of osseous variations of the FT (hypoplastic + double FT) in C1 is high (35.7%) compared with previous studies.
- The coefficient of roundness for C1, when pooling both sexes and sides, is classified as brachymorph (i.e., mediolateral diameter exceeding anteroposterior), contrasting with previous studies in which C1 FT is typically classified as mesomorph.
- The prevalence of bony bridges in C1, particularly PP (52.9%) and RTF (64.7%), is markedly higher than in most published reports.
- The distribution of FT variations in number, size, and shape, as well as the prevalence of bony bridges in C1, appears relatively homogeneous between sexes, with no statistically significant sex-based differences.
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
Abbreviations
VA | Vertebral artery |
SCA | Subclavian artery |
BA | Basilar artery |
VBI | Vertebrobasilar insufficiency |
FT | Foramen transversarium |
PP | Ponticulus posticus |
PL | Ponticulus lateralis |
RTF | Retrotransverse foramen |
R | Coefficient of roundness |
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Males | Females | Unknown Sex | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Cervical Level | YA | MAA | SA | YA | MAA | SA | YA | MAA | SA | Total |
C1 | 3 | 6 | 0 | 1 | 6 | 1 | 0 | 0 | 0 | 17 |
C2 | 4 | 5 | 0 | 2 | 7 | 1 | 0 | 1 | 0 | 20 |
C3 | 3 | 5 | 0 | 1 | 7 | 2 | 0 | 0 | 0 | 18 |
C4 | 3 | 5 | 0 | 1 | 7 | 2 | 0 | 1 | 0 | 19 |
C5 | 4 | 5 | 0 | 1 | 7 | 2 | 0 | 1 | 0 | 20 |
C6 | 4 | 5 | 0 | 1 | 7 | 2 | 0 | 1 | 0 | 20 |
C7 | 4 | 7 | 0 | 1 | 5 | 2 | 2 | 1 | 0 | 22 |
Total | 25 | 38 | 0 | 8 | 46 | 12 | 2 | 5 | 0 | 136 |
Cervical Level | Excluded Vertebrae due to Limiting Factors | Normal Vertebrae [n (%)] | Osseous Variants of the Foramen Transversarium [n (%)] | Total [n (%)] | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Absence | Hypoplastic | Complete Double | Incomplete Double | Multiple | Complete + Incomplete Double | |||||||||||||
UL | BL | UL | BL | UL | BL | UL | BL | UL | BL | |||||||||
C1 | 3 | 9 (8.33) | 0 (0) | 0 (0) | 1 (0.93) | 0 (0) | 3 (2.78) | 0 (0) | 1 (0.93) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 14 (12.97) | ||||
C2 | 4 | 16 (14.81) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 16 (14.81) | ||||
C3 | 2 | 15 (13.89) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (0.93) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 16 (14.81) | ||||
C4 | 3 | 14 (12.96) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (0.93) | 1 (0.93) | 0 (0) | 0 (0) | 0 (0) | 16 (14.81) | ||||
C5 | 4 | 8 (7.41) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (1.85) | 5 (4.63) | 0 (0) | 1 (0.93) | 0 (0) | 0 (0) | 16 (14.81) | ||||
C6 | 7 | 3 (2.78) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 3 (2.78) | 0 (0) | 6 (5.56) | 0 (0) | 0 (0) | 0 (0) | 1 (0.93) | 13 (12.04) | ||||
C7 | 5 | 11 (10.19) | 0 (0) | 0 (0) | 1 (0.93) | 0 (0) | 1 (0.93) | 0 (0) | 2 (1.85) | 1 (0.93) | 0 (0) | 0 (0) | 1 (0.93) | 17 (15.75) | ||||
Total | 28 | 76 (70.37) | 0 (0) | 0 (0) | 2 (1.85) | 0 (0) | 7 (6.48) | 2 (1.85) | 16 (14.81) | 2 (1.85) | 1 (0.93) | 0 (0) | 2 (1.85) | 108 (100) |
Males | Females | Comparison of Differences | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cervical Level | Right | Left | Right | Left | By Sex | By Laterality | |||||||
Diameter | n | Measure | n | Measure | n | Measure | n | Measure | U | p | U | p | |
C1 | A–P | 5 | 7.55 ± 1.09 | 6 | 7.17 ± 1.07 | 5 | 6.56 ± 0.96 | 3 | 6.63 ± 0.21 | 33.00 | 0.364 | 34.00 | 0.369 |
M–L | 5 | 6.14 ± 1.48 | 6 | 6.48 ± 0.90 | 5 | 6.44 ± 1.09 | 3 | 6.03 ± 0.54 | 39.00 | 0.680 | 43.00 | 0.870 | |
R | 5 | 80.27 ± 9.92 | 6 | 91.01 ± 12.12 | 5 | 98.91 ± 14.19 | 3 | 90.92 ± 7.77 | 23.00 | 0.083 | 41.00 | 0.744 | |
C2 | A–P | 7 | 5.18 ± 0.81 | 6 | 6.02 ± 1.04 | 8 | 6.63 ± 1.27 | 7 | 5.68 ± 0.71 | 63.00 | 0.112 | 108.50 | 0.884 |
M–L | 7 | 5.85 ± 1.30 | 6 | 6.38 ± 0.91 | 8 | 6.39 ± 0.83 | 7 | 6.07 ± 2.04 | 88.00 | 0.662 | 107.50 | 0.852 | |
R | 7 | 112.94 ± 21.63 | 6 | 106.88 ± 12.03 | 8 | 98.42 ± 16.52 | 7 | 106.91 ± 33.96 | 82.00 | 0.475 | 92.00 | 0.406 | |
C3 | A–P | 7 | 4.98 ± 0.87 | 5 | 5.63 ± 0.54 | 4 | 5.36 ± 0.81 | 6 | 4.92 ± 0.54 | 54.00 | 0.692 | 53.00 | 0.622 |
M–L | 7 | 6.18 ± 0.91 | 5 | 6.92 ± 0.75 | 4 | 6.71 ± 0.56 | 5 | 6.60 ± 0.36 | 47.50 | 0.644 | 37.50 | 0.218 | |
R | 7 | 124.82 ± 8.92 | 5 | 123.01 ± 6.72 | 4 | 126.77 ± 16.59 | 5 | 139.21 ± 16.92 | 35.00 | 0.177 | 46.00 | 0.526 | |
C4 | A–P | 5 | 4.96 ± 0.78 | 6 | 5.78 ± 1.04 | 8 | 5.54 ± 0.77 | 5 | 5.35 ± 1.07 | 70.00 | 0.931 | 66.00 | 0.514 |
M–L | 5 | 6.49 ± 1.03 | 6 | 7.05 ± 1.11 | 7 | 6.46 ± 0.71 | 5 | 6.55 ± 0.63 | 52.00 | 0.389 | 56.00 | 0.356 | |
R | 5 | 131.30 ± 13.56 | 6 | 122.72 ± 12.20 | 7 | 120.42 ± 19.36 | 5 | 127.16 ± 34.91 | 57.00 | 0.580 | 55.00 | 0.326 | |
C5 | A–P | 4 | 5.26 ± 0.85 | 4 | 6.14 ± 0.75 | 1 | 5.65 | 2 | 5.27 ± 0.46 | 8.00 | 0.414 | 9.00 | 0.273 |
M–L | 5 | 6.23 ± 1.07 | 4 | 6.97 ± 0.57 | 1 | 6.55 | 2 | 5.50 ± 1.22 | 8.00 | 0.309 | 16.00 | 0.749 | |
R | 4 | 114.00 ± 13.63 | 4 | 114.34 ± 11.08 | 1 | 115.93 | 2 | 105.88 ± 32.34 | 11.00 | 0.838 | 13.00 | 0.715 | |
C6 | A–P | 3 | 5.80 ± 1.69 | 2 | 6.10 ± 1.50 | 0 | — | 2 | 5.76 ± 1.32 | 4.00 | 0.699 | 7.00 | 0.773 |
M–L | 3 | 6.06 ± 0.99 | 2 | 6.76 ± 1.85 | 1 | 4.35 | 2 | 6.10 ± 0.82 | 5.00 | 0.456 | 8.00 | 0.624 | |
R | 3 | 106.60 ± 12.74 | 2 | 110.42 ± 3.23 | 0 | — | 2 | 107.07 ± 10.21 | 5.00 | 1.000 | 6.00 | 0.564 | |
C7 | A–P | 3 | 3.25 ± 0.27 | 6 | 3.73 ± 0.93 | 4 | 3.94 ± 0.79 | 3 | 3.59 ± 1.05 | 24.00 | 0.427 | 34.00 | 0.922 |
M–L | 3 | 3.95 ± 0.64 | 6 | 4.51 ± 1.02 | 4 | 4.80 ± 1.03 | 3 | 4.61 ± 1.41 | 23.00 | 0.368 | 31.00 | 0.696 | |
R | 3 | 122.32 ± 22.88 | 6 | 123.01 ± 20.16 | 4 | 122.29 ± 15.74 | 3 | 128.48 ± 18.53 | 29.00 | 0.791 | 26.00 | 0.380 |
Presence of Osseous Variants in Vertebra C1 [n (%)] | ||||||||
---|---|---|---|---|---|---|---|---|
Normal Vertebra C1 [n (%)] | Complete | Incomplete | ||||||
Osseous Variant | Unilateral | Bilateral | Unilateral | Bilateral | Complete + Incomplete | Total | ||
Ponticulus posticus | 8 (47.06) | 3 (17.65) | 0 (0) | 2 (11.76) | 2 (11.76) | 2 (11.76) | 17 (100.0) | |
Ponticulus lateralis | 16 (94.12) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (5.88) | 17 (100.0) | |
Retrotransverse foramen | 6 (35.29) | 0 (0) | 1 (5.88) | 7 (41.18) | 2 (11.76) | 1 (5.88) | 17 (100.0) |
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Amores, A.; Tanga, C.; Somma, M.C.; La Salvia, V.; Antonelli, S.; Viciano, J. Osseous Variants of the Cervical Spine with Potential Pathological Significance: Possible Evidence of Vertebrobasilar Insufficiency in a Skeletal Sample from the Post-Classical Cemetery of Corfinio (12th–15th Centuries CE, L’Aquila, Italy). Heritage 2025, 8, 178. https://doi.org/10.3390/heritage8050178
Amores A, Tanga C, Somma MC, La Salvia V, Antonelli S, Viciano J. Osseous Variants of the Cervical Spine with Potential Pathological Significance: Possible Evidence of Vertebrobasilar Insufficiency in a Skeletal Sample from the Post-Classical Cemetery of Corfinio (12th–15th Centuries CE, L’Aquila, Italy). Heritage. 2025; 8(5):178. https://doi.org/10.3390/heritage8050178
Chicago/Turabian StyleAmores, Anabel, Carmen Tanga, Maria Carla Somma, Vasco La Salvia, Sonia Antonelli, and Joan Viciano. 2025. "Osseous Variants of the Cervical Spine with Potential Pathological Significance: Possible Evidence of Vertebrobasilar Insufficiency in a Skeletal Sample from the Post-Classical Cemetery of Corfinio (12th–15th Centuries CE, L’Aquila, Italy)" Heritage 8, no. 5: 178. https://doi.org/10.3390/heritage8050178
APA StyleAmores, A., Tanga, C., Somma, M. C., La Salvia, V., Antonelli, S., & Viciano, J. (2025). Osseous Variants of the Cervical Spine with Potential Pathological Significance: Possible Evidence of Vertebrobasilar Insufficiency in a Skeletal Sample from the Post-Classical Cemetery of Corfinio (12th–15th Centuries CE, L’Aquila, Italy). Heritage, 8(5), 178. https://doi.org/10.3390/heritage8050178