How common is the Ponticulus Posticus? A CT based analysis of 2,917 Patients

STUDY DESIGN:A CT study of the morphology of the C1 vertebra OBJECTIVE:is to determine the prevalence of PP by analyzing CT scans performed on a large, diverse population in the northeast United States. This study also proposes a CT based classification system both to aid in unifying the description of PP, and to aid in future research. SUMMARY OF BACKGROUND DATA:The prevalence of ponticulusposticus (PP) varies from 5%-68% in published studies. There may be geographic variation in the prevalence of PP. Our objective was to establish the prevalence of PP in the general population, and to develop a comprehensive classification system to describe PP. METHODS:We evaluated cervical spine computed tomography (CT) scans performed on patients in the emergency room of a level I trauma center over a one-year period (1/1/2014 - 12/31/2014). The CT images were evaluated for the presence of a ponticulusposticus, and if present the following demographic data was collectedage, sex, race/ethnicity, and BMI. We propose a novel classification system to standardize the description of ponticulusposticus identified on CT scan. RESULTS:Two thousand, nine hundred and seventeen cervical spine CT scans were reviewed in this study. The prevalence of PP was 22.5%. Men had a higher prevalence of PP than women (53.5% male versus 46.5% female p=