Chang Victor, Basheer Azam, Baumer Timothy, Oravec Daniel, McDonald Colin P, Bey Michael J, Bartol Stephen, Yeni Yener N
Department of Neurosurgery, Henry Ford Hospital, K-11, 2799W. Grand Blvd, Detroit, MI, USA.
Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, MI, USA.
Surg Radiol Anat. 2017 Oct;39(10):1069-1078. doi: 10.1007/s00276-017-1847-6. Epub 2017 Mar 25.
Neural foraminal dimensions are considered important in nerve root compression and development of cervical radiculopathy, but baseline data regarding their range during normal motion are not available. An in vivo study of cervical foraminal motion was conducted to characterize normal 3D dynamic foraminal dimensions during physiological neck motion and compare between different tasks and intervertebral segments.
Biplane X-ray imaging and computed tomography-based markerless tracking were used to measure foraminal height (FH) and width (FW) from five asymptomatic subjects during neck axial rotation and extension. FH and FW were quantified as the minimum (SI.Min and AP.Min), range (SI.Range and AP.Range), and median (SI.Med and AP.Med) of superoinferior (SI) and anteroposterior (AP) dimensions for each trial and as the coefficient of variation of these variables from three trials (SI.Med.CV and AP.Med.CV, SI.Range.CV and AP.Range.CV) at C3-4 through C6-7 levels for each subject. Differences were analyzed using mixed model ANOVA.
AP.Range and AP.Med.CV were greater (P < 0.0001) while AP.Min and AP.Range.CV were smaller (P < 0.0006 and P < 0.0005) during neck extension than rotation. SI.Range and SI.Med.CV were greater for extension than rotation at C5-6 (P < 0.002 and P < 0.03), whereas SI.Med.CV was greater for rotation than extension at C3-4 (P < 0.03). AP.Range (P < 0.02), AP.Med.CV (P < 0.05), SI.Range (P < 0.0004), and SI.Med.CV (P < 0.02) were different between cervical levels, the latter two being during extension only.
Patterns of FH and FW during normal motion are different between tasks and cervical levels. These findings are expected to provide a basis for future studies of spinal degeneration and surgical efficacy.
神经孔尺寸在神经根受压和颈椎病的发展中被认为很重要，但关于其在正常活动期间范围的基线数据尚无可用。进行了一项颈椎孔运动的体内研究，以表征生理颈部运动期间正常的三维动态孔尺寸，并比较不同任务和椎间节段之间的差异。
使用双平面X射线成像和基于计算机断层扫描的无标记跟踪技术，在颈部轴向旋转和伸展过程中测量了五名无症状受试者的椎间孔高度（FH）和宽度（FW）。FH和FW被量化为每个试验的上下（SI）和前后（AP）尺寸的最小值（SI.Min和AP.Min）、范围（SI.Range和AP.Range）和中位数（SI.Med和AP.Med），以及每个受试者在C3-4至C6-7水平上三次试验中这些变量的变异系数（SI.Med.CV和AP.Med.CV，SI.Range.CV和AP.Range.CV）。使用混合模型方差分析来分析差异。
在颈部伸展期间，AP.Range和AP.Med.CV更大（P < 0.0001），而AP.Min和AP.Range.CV更小（P < 0.0006和P < 0.0005）。在C5-6水平，SI.Range和SI.Med.CV在伸展时比旋转时更大（P < 0.002和P < 0.03），而在C3-4水平，SI.Med.CV在旋转时比伸展时更大（P < 0.03）。颈椎节段之间的AP.Range（P < 0.02）、AP.Med.CV（P < 0.05）、SI.Range（P < 0.0004）和SI.Med.CV（P < 0.02）不同，后两者仅在伸展期间存在差异。
正常活动期间FH和FW的模式在任务和颈椎节段之间有所不同。这些发现有望为未来脊柱退变和手术疗效的研究提供基础。
