{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:22:20Z","timestamp":1787840540937,"version":"build-2784847793"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>To compare axial and sagittal C2 pedicle-related morphometric parameters between patients with rheumatoid arthritis (RA) and healthy controls, with specific emphasis on the prevalence of a high-riding vertebral artery (HRVA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study analyzed cervical computed tomography (CT) scans of 30 patients with RA and 194 healthy individuals. Bilateral axial and sagittal C2 pedicle-related parameters, including pedicle width, length, angulation, isthmus height, and internal height, were measured. HRVA was defined as an isthmus height of \u2264 5 mm and\/or an internal height of \u2264 2 mm. Morphometric parameters and HRVA prevalence were compared between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No significant differences were observed between the groups regarding pedicle angles, lengths, or widths. However, patients with RA demonstrated significantly reduced right-sided isthmus height and internal height compared with controls. In addition, the prevalence of HRVA was significantly higher in the RA group on both sides.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>RA is associated with distinct C2 morphometric alterations, particularly reduced right-sided isthmus and internal heights and a higher prevalence of HRVA. These findings have important implications for posterior cervical fixation, underscoring the need for meticulous preoperative CT-based morphometric assessment to optimize surgical planning and enhance neurovascular safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_3_26","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:00:08Z","timestamp":1773838808000},"page":"181-187","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Morphometric characteristics of the C2 vertebra and high-riding vertebral artery at the craniovertebral junction in rheumatoid arthritis"],"prefix":"10.4103","volume":"17","author":[{"given":"Birol","family":"\u00d6zkal","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yal\u00e7\u0131n","family":"G\u00fcney","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"\u00d6z\u00e7elik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"R2-20260319","first-page":"90","article-title":"Prevalence of radiological changes in the cervical spine \u2013 A cross sectional study after 20 years from presentation of rheumatoid arthritis","volume":"27","author":"Neva","year":"2000","journal-title":"J Rheumatol"},{"key":"R3-20260319","first-page":"1","article-title":"Morphometric study of second cervical vertebra: A dry bone study","volume":"14","author":"Avisikta","year":"2025","journal-title":"J Neonatal Surg"},{"key":"R4-20260319","doi-asserted-by":"crossref","first-page":"e88970","DOI":"10.1371\/journal.pone.0088970","article-title":"Accelerated development of cervical spine instabilities in rheumatoid arthritis: A prospective minimum 5-year cohort study","volume":"9","author":"Yurube","year":"2014","journal-title":"PLoS One"},{"key":"R5-20260319","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.autrev.2014.08.014","article-title":"Cervical spine involvement in rheumatoid arthritis \u2013 A systematic review","volume":"13","author":"Joaquim","year":"2014","journal-title":"Autoimmun Rev"},{"key":"R6-20260319","doi-asserted-by":"crossref","first-page":"E513","DOI":"10.1097\/01.brs.0000224516.29747.52","article-title":"Comparison of the anatomical risk for vertebral artery injury associated with the C2-pedicle screw and atlantoaxial transarticular screw","volume":"31","author":"Yoshida","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"R7-20260319","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/00007632-199603150-00005","article-title":"Anatomic consideration of C2 pedicle screw placement","volume":"21","author":"Ebraheim","year":"1996","journal-title":"Spine (Phila Pa 1976)"},{"key":"R8-20260319","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.4184\/asj.2016.10.6.1141","article-title":"Prevalence of high-riding vertebral artery and morphometry of C2 pedicles using a novel computed tomography reconstruction technique","volume":"10","author":"Wajanavisit","year":"2016","journal-title":"Asian Spine J"},{"key":"R9-20260319","first-page":"338","article-title":"Craniovertebral realignment for basilar invagination and atlantoaxial dislocation secondary to rheumatoid arthritis","volume":"52","author":"Goel","year":"2004","journal-title":"Neurol India"},{"key":"R10-20260319","doi-asserted-by":"crossref","first-page":"238","DOI":"10.4103\/0028-3886.16424","article-title":"Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis","volume":"53","author":"Goel","year":"2005","journal-title":"Neurol India"},{"key":"R11-20260319","doi-asserted-by":"crossref","first-page":"273","DOI":"10.3171\/SPI\/2008\/9\/9\/273","article-title":"Immediate postoperative regression of retroodontoid pannus after lateral mass reconstruction in a patient with rheumatoid disease of the craniovertebral junction. 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