Discriminant Function Analysis of Foramen Magnum Variables in South Indian Population: A Study of Computerised Tomographic Images.

Abstract

Background and objectives: The foramen magnum as a transition area between skull and spine plays an important role as a landmark, because of its close relationship to vital structures such as the brain and spinal cord. Configuration and size of the foramen magnum play an important role for assessing craniovertebral relations. The objectives of the present study are to find out shape and dimensions of foramen magnum in cranial CT scans. All the variables were evaluated by using discriminant function analysis.

Materials and methods: The study sample comprised 200 CT scans (110 males and 90 females) of south Indian origin. The shapes of the foramen magnum were classified into 8 types: oval, egg, round, tetragonal, pentagonal, hexagonal, irregular (A), and irregular (B). The parameters were noted meticulously and the statistical analysis for sex comparison was made by Student's t-test and was considered significant whenever P≤0.05. To determine the relationships between the studied parameters, Pearson correlation coefficients were calculated.

Results: The foramen magnum was classified into 8 types based on shape. Commonest was oval and pentagonal was the least common type. The anteroposterior diameter, transverse diameter, circumference, and area were significantly greater in males than in females (P<0.001). The mean FM index of male CT scans was 85.01 ± 8.67, whereas in case of female CT scans, it was 83.17 ± 7.78. With all the variables in consideration, overall 65% of cranial CT scans were sexed correctly by using multivariate analysis.

Conclusion: Several anatomic parameters such as shape and dimensions of FM should be taken into consideration during surgery involving the craniovertebral junction. Also these can be used during forensic and anthropological investigation of unknown individuals for determining gender, ethnicity, and so on. The multivariate analysis is by far the best method for determination of sex of cranium with available resources.