Ponticulus posticus – Is it a rare anomaly?

Objectives: Radiologists play an important role in evaluation of anatomical landmarks and anomalies associated with the same. In the atlas vertebra one such anomaly seen is the Ponticulus Posticus, which is a bony arch enclosing the foramen through which the vertebral artery passes. Some suggest that this anomaly has a protecting effect on the artery from external injury and few suggest that they cause compression of the artery leading to headache and migraine. Objective of this study was to assess the prevalence of Ponticulus Posticus with age and sex distribution and morphological variations among the South Indian population between age groups 15-55 years using Digital cephalometry. Methods: The study was conducted in the Department of Oral medicine and radiology, A.E.C.S Maaruti College of Dental Sciences And Research Centre Bangalore. A total of 400 patients in the age group of 15-55years were recruited for the study. Digital lateral cephalograms were taken and examined for the presence of Ponticulus Posticus and further evaluated and recorded for partial or complete forms. Results: Among 400 subjects the study showed a significant prevalence of 34.8%. Females (62.3%) and age group of 15-25 years (46%) showed a higher prevalence of Ponticulus Posticus. 23.8% showed presence of partial ossification and 11% showed complete ossification. Conclusion: Hence we conclude that Ponticulus Posticus is not such a rare anomaly. Lateral cephalogram must be considered as one of the basic screening tools for detection of these kind of anomalies of spine and radiologists should pay attention to the same.