Yamahata Hitoshi, Hirano Hirofumi, Yamaguchi Satoshi, Mori Masanao, Niiro Tadaaki, Tokimura Hiroshi, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University.
Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences.
Neurol Med Chir (Tokyo). 2017 Sep 15;57(9):461-466. doi: 10.2176/nmc.oa.2017-0055. Epub 2017 Jul 27.
The spinal canal diameter (SCD) is one of the most studied factors for the assessment of cervical spinal canal stenosis. The inner anteroposterior diameter (IAP), the SCD, and the cross-sectional area (CSA) of the atlas have been used for the evaluation of the size of the atlas in patients with atlas hypoplasia, a rare form of developmental spinal canal stenosis, however, there is little information on their relationship. The aim of this study was to identify the most useful parameter for depicting the size of the atlas. The CSA, the IAP, and the SCD were measured on computed tomography (CT) images at the C1 level of 213 patients and compared in this retrospective study. These three parameters increased with increasing patient height and weight. There was a strong correlation between IAP and SCD (r = 0.853) or CSA (r = 0.822), while correlation between SCD and CSA (r = 0.695) was weaker than between IAP and CSA. Partial correlation analysis showed that IAP was positively correlated with SCD (r = 0.687) and CSA (r = 0.612) when CSA or SCD were controlled. SCD was negatively correlated with CSA when IAP was controlled (r = -0.21). The IAP can serve as the CSA for the evaluation of the size of the atlas ring, while the SCD does not correlate with the CSA. As the patient height and weight affect the size of the atlas, analysis of the spinal canal at the C1 level should take into account physiologic patient data.
椎管直径（SCD）是评估颈椎管狭窄时研究最多的因素之一。寰椎的内前后径（IAP）、SCD和横截面积（CSA）已被用于评估寰椎发育不全患者的寰椎大小，寰椎发育不全是一种罕见的发育性椎管狭窄形式，然而，关于它们之间的关系却知之甚少。本研究的目的是确定描绘寰椎大小最有用的参数。在213例患者的C1水平计算机断层扫描（CT）图像上测量CSA、IAP和SCD，并在这项回顾性研究中进行比较。这三个参数随着患者身高和体重的增加而增加。IAP与SCD（r = 0.853）或CSA（r = 0.822）之间存在强相关性，而SCD与CSA之间的相关性（r = 0.695）弱于IAP与CSA之间的相关性。偏相关分析表明，当控制CSA或SCD时，IAP与SCD（r = 0.687）和CSA（r = 0.612）呈正相关。当控制IAP时，SCD与CSA呈负相关（r = -0.21）。IAP可作为评估寰椎环大小的CSA，而SCD与CSA不相关。由于患者身高和体重会影响寰椎大小，因此在分析C1水平的椎管时应考虑患者的生理数据。
