Assessment of Craniocervical

Angulation

ASSESSMENT OF CRANIOCERVICAL
ANGULATION

Landmarks and definitions

ANS (sp) – spinal point – the apex of the anterior nasal spins (Bjork, 1947);

Ba- basion- the most posteroinferior point on the anterior margin of the foramen

magnum (Solow and Tallgren, 1976);

Cv2ap – the apex of the odontoid process of the second cervical vertebrae (Solow

vertebrae (Solow and Tallgren, 1971);

Cv4ip – the most posterior and inferior point on the corpus of the fourth cervical

vertebrae (Solow and Tallgren, 1971);

Cv6ip – the most posterior and inferior point on the corpus of the sixth cervical

vertebraie (Hellsing and Hagberg, 1990);

Cv2tg – tangent point of OPT on the odontoid process of the second cervical

vertebrae (Solow and Tallgren, 1971);

Gn – Gnathion – the most inferior point on the mandibular symphysis (Bjork

1947).

N – Nasion – the most anterior point of the frontonasal suture (Bjork, 1947);

I – opisthion – the most anteroinferior point of the posterior margin of the oramen

magnum (Solow and Tallgren, 1976);

O – orbitale –the most inferior point of the orbit (Bjork, 1947);

P – Porion – the most superior point of the external auditory meatus (Bjork, 1947)

52
 Assessment of Craniocervical
Angulation
Ptm (pm) – pterygomaxillary point – the intersection between the nasal floor and

the posterior contour of the maxilla (Bjork, 1947);

Cephalometric reference points and lines for assessment of craniocervical

angulation

REFERENCE LINES

CVI – the cervical vertebrae tangent – the posterior tangent to the odontoid

process through cv4ip (Bjork, 1960);

EVI – the lower part of the cervical spine – the line through cv4ip and cv6ip

(Hellsing and Hagberg, 1990);

FH – Frankfort horizontal – line connecting the points porion (po) and orbitale (on

EML (FOR) – the foramen magnum line – line connecting basion (ba) and

apisthion (o) (Solow and Tallgren, 1976; Huggare, 1991);

HOR – true horizontal line – the line perpendicular to VER (Solow and Tallgren,

1971);

53
 Assessment of Craniocervical
Angulation
ML – mandibular line – tangent line to the lower border of the mandible (on point

go) through gnathion (gn) (Bjork, 1947);

NL – nasal line – line connecting the anterior nasal spine (ans or sp) and

pterygomaxillare (Ptm) (Bjork, 1947);

NSL – the anterior cranial base – line connecting the center of sella turcica (s) and

nasion (n) (Bjork,1947);

OPT – the odontoid process tangent. The posterior tangent to the odontoid

process through cx2ip (Solow and Tallgren 1971);

RI – the ramus plane – tangent line on the posterior contour of ramus ascentens

(Bjork, 1947);

VFR – true vertical line – the vertical line – the vertical line projected on the film

(Solow and Tallgren, 1976)

VARIABLES

Cv2ap – cv4ip – the length of the cervical column- linear distance between the

point cv2ap and cv4ip (Solow and Tallgren, 1976);

CVT – EVT –the cervical lordosis – angle between the cervical vertebrae tangent

(CVT) and the EVT line (Hellsing and Hagberg, 1990);

CVT – FH – the inclination of the cervical column in relation to the Frankfort

horizontal line- angle between the cervical vertebrae tangent (CVT) and the FH

line (Solow et al, 1993);

CVT – EML – angle between the cervical vertebra tangent (CVT) and the

foramina magnum line (FML) (Solow and Tallgren, 1976);

54
 Assessment of Craniocervical
Angulation
CVT – HOR – the inclination of cervical column to the true horizontal – angle

between the cervical vertebrae tangent (CVT) and the horizontal line (HOR –

Solow and Tallgren, 1971).

CVT-ML – the head position in relation to the cervical column – angle between

the cervical vertebrae tangent (CVT) and the ML line (Solow and Tallgren, 1971);

CVT – NL – the head position in relation to the cervical column – angle between

the cervical vertebrae tangent (CVT) and the NL line (Solow and Tallgren, 1971);

CVT – NSL – the head position in relation to the cervical column- angle between

the cervical vertebrae tangent (CVT) and the NSL line (Solow and Tallgren,

1971);

CVT – RL – the head position in relation to the cervical column – angle between

the cervical vertebrae tangent (CVT) and the RL line (Solow and Tallgren, 1971);

OPT – CVT – the inclination of the two cervical reference lines to each other, i.e.,

the cervical curvature – angle between the odontoid process tangent (OPT) and the

cervical vertebrae tangent (CVT) (Solow and Tallgren, 1976);

OPT – FH – the inclination of the cervical column in relation to the Frankfort

horizontal line – angle between the odontoid process tangent (OPT) and the FH

line (Solow et al, 1993);

OPT – FML – angle between the odontoid process tangent (OPT) and the

foramen magnum line (FML) (Solow and Tallgren, 1976);

OPT – HOR – the inclination of cervical column to the true horizontal – angle

between the odontoid process tangent 9OPT) and the horizontal line (HOR)

(Solow and Tallgren, 1971);

55
 Assessment of Craniocervical
Angulation
OPT – ML – the head position in relation to the cervical column – angle between

the odontoid process tangent (OPT) and the ML line (Solow and Tallgren, 1971);

OPT – NL – the head position in relation to the cervical column – angle between

the odontoid process tangent (OPT) and the NL line (Solow and Tallgren, 1971);

OPT – NSL – the head position in relation to the cervical column – angle between

the odontoid process tangent (OPT) and the NSL line (Solow and Tallgren, 1971);

OPT – RL – the head position in relation to the cervical column – angle between

the dentoid process tangent (OPT) and the RL line (Solow and Tallgren, 1971).

56