Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Global Spine J. 2015 Oct;5(5):383-90. doi: 10.1055/s-0035-1550091. Epub 2015 Apr 29.
Study Design Computed tomography-based cohort study. Objective Although there are publications concerning the relationship between the vertebral artery and uncinate process, there is no practical guide detailing the dimensions of this region to use during decompression of the intervertebral foramen. The purpose of this study is to determine the anatomic parameters that can be used as a guide for thorough decompression of the intervertebral foramen. Methods Fifty-one patients with three-dimensional computed tomography scans of the cervical spine from 2003 to 2012 were included. On axial views, we measured the distance from the midline to the medial and lateral cortices of the pedicle bilaterally from C3 to C7. On coronal reconstructed views, we measured the minimum height of the uncinate process from the cranial cortex of the pedicle adjacent to the posterior cortex of vertebral body and the maximal height of the uncinate process from the cranial cortex of the pedicle at the midportion of the vertebral body bilaterally from C3 to C7. Results The mean distances from midline to the medial and lateral cortices of the pedicle were 10.1 ± 1.3 mm and 13.9 ± 1.5 mm, respectively. The mean minimum height of the uncinate process from the cranial cortex of the pedicle was 4.6 ± 1.6 mm and the mean maximal height was 6.1 ± 1.7 mm. Conclusions Our results suggest that in most cases, one can thoroughly decompress the intervertebral foramen by removing the uncinate out to 13 mm laterally from the midline and 4 mm above the pedicle without violating the transverse foramen.
基于计算机断层扫描的队列研究。目的：虽然有关于椎动脉与钩突关系的出版物，但没有实用的指南详细描述该区域的尺寸，以便在椎间孔减压时使用。本研究的目的是确定可作为椎间孔充分减压指南的解剖参数。方法：纳入 2003 年至 2012 年的 51 例颈椎三维计算机断层扫描患者。在轴位视图上，我们测量了从 C3 到 C7 双侧椎弓根中线到内侧和外侧皮质的距离。在冠状重建视图上，我们测量了从邻近椎体后皮质的椎弓根颅侧皮质到 C3 到 C7 双侧椎弓根体中部颅侧皮质的钩突最小高度和最大高度。结果：椎弓根中线到内侧和外侧皮质的平均距离分别为 10.1±1.3mm 和 13.9±1.5mm。从椎弓根颅侧皮质到钩突最小高度的平均值为 4.6±1.6mm，最大高度为 6.1±1.7mm。结论：我们的结果表明，在大多数情况下，通过从中线向外侧切除 13mm 并在椎弓根上方 4mm 处切除钩突，可以彻底减压椎间孔，而不会侵犯横突孔。
