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Review
. 2017 Jan 17;9(1):e981.
doi: 10.7759/cureus.981.

The Dens: A Review of its Diverse Nomenclature and a Recommended Simplified Terminology

Jaspreet Johal  1 , Christian Fisahn  2 , Brittni Burgess  3 , Marios Loukas  1 , Jens Chapman  4 , Rod J Oskouian  5 , R Shane Tubbs  6
Affiliations
Review

The Dens: A Review of its Diverse Nomenclature and a Recommended Simplified Terminology

Jaspreet Johal et al. Cureus. .

Abstract

Pathology of the dens, such as fractures, demands precise terminology so that communication between physicians are succinct, diagnoses are accurate, and treatment strategies exact. This review aims to summarize the various terms used to describe the parts of the dens and recommend the ideal terminology. Using standard search engines, English language publications were searched for the many terms used to describe parts of the dens. A multitude of terms was identified with many demonstrating overlaps. Terms identified included apex, tip, apicodental, subdental, dentocentral and odontocentral junctions, peg, waist, base, neck, shaft, shoulder, and stem. Exact terminology is necessary when diagnosing or treating patients with pathology of or near the dens. The authors suggest simplified terminology for describing the parts of the dens that can be used in the future in order to be unequivocal and to avoid confusion when classifying and communicating fractures through its parts.

Keywords: anatomy; c2 vertebra; craniocervical junction; odontoid process; terminology.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. 3D reconstructed CT image of C2 noting various terms used to describe parts of the dens.
Figure 2
Figure 2. 3D reconstructed CT image of C2 noting various terms used to describe parts of the dens.
Figure 3
Figure 3. 3D reconstructed CT image of C2 noting various terms used to describe parts of the dens.
Figure 4
Figure 4. CT scan through a C2 specimen noting the various terms used to describe the fusion points of the dens.
Figure 5
Figure 5. Schematic of ossification centers of the C2 vertebra.
The most superior aspect of the dens is shown at A, the junction between the dens and neural arches is shown at B, and the junction between the neural arches and the body of C2 is shown at C. This figure has been modified after Akobo, et al., Childs Nerv Syst (2015) 31:2025–34.
Figure 6
Figure 6. Suggested terminology for simplifying the terms used to describe parts of the dens.
Zones I and II are used to describe the upper 1/4th and lower 3/4th of the dens.
Figure 7
Figure 7. 3D CT reconstruction of C2.
Zones I and II are based on defining the dens (vertical line) as the midline portion of C2 that fuses with its body at the synchondrosis (horizontal line).
See this image and copyright information in PMC

References

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