Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Orthopedics, Guangzhou General Hospital of Guangzhou Military Command (Liuhuaqiao Hospital), Guangzhou, China.
Spine (Phila Pa 1976). 2018 Nov 15;43(22):E1305-E1312. doi: 10.1097/BRS.0000000000002706.
A retrospective analysis of collected data.
Our study aims to present the morphology of cranial-cervical spinal canal in basilar invagination (BI) patients.
BI is characterized by protrusion of the odontoid process into the foramen magnum (C0), leading to compression of the cervicomedullary junction. However, no study has ever clarified the anatomical diameters of spinal canal in patients with BI.
The study retrospectively examined computed tomography (CT)-based anatomical characteristics in a cohort of 84 patients with and without BI. We measured the anteroposterior diameter (APD) and transversal diameter (TVD) of spinal canal from C0 to C4, together with the area of vertebral canal (Area). Independent samples t test was used for statistical analysis.
The APD in the BI group was shorter than the control group from C0 to C2 (C0: 27.98 vs. 35.11 mm, P < 0.001; C1: 11.87 vs. 16.91 mm, P < 0.001; C2: 12.91 vs. 14.84 mm, P < 0.001), but it became longer from C3 to C4. The TVD of the BI group was significantly wider from C0 to C3 (C0: 30.59 vs. 28.54 mm, P < 0.001; C1: 31.31 vs. 25.98 mm, P < 0.001; C2: 21.56 vs. 20.40 mm, P = 0.01; C3: 22.45 vs. 21.23 mm, P = 0.013), and it had no significance at C4. The Area showed no difference between the two groups from C1 to C2, but it turned larger at C3 and C4 in BI patients.
BI patients may have shorter APD from C0 to C2, which could be the leading cause of neurological compression, necessitating decompression on sagittal plane. Below the pathological levels, BI patients have larger spinal canal than general population.
回顾性数据分析。
我们的研究旨在展示颅颈交界区后颅底凹陷症（basilar invagination，BI）患者颅颈椎管的形态学特征。
BI 的特征是齿状突突入颅后窝（C0），导致颈髓交界处受压。然而，尚无研究明确 BI 患者椎管的解剖学直径。
本研究回顾性分析了 84 例 BI 患者和非 BI 患者的基于 CT 的解剖特征。我们测量了从 C0 到 C4 的椎管前后径（anteroposterior diameter，APD）和横径（transversal diameter，TVD）以及椎管面积（area）。采用独立样本 t 检验进行统计学分析。
BI 组的 APD 从 C0 到 C2 均短于对照组（C0：27.98 毫米比 35.11 毫米，P < 0.001；C1：11.87 毫米比 16.91 毫米，P < 0.001；C2：12.91 毫米比 14.84 毫米，P < 0.001），但从 C3 到 C4 逐渐变长。BI 组的 TVD 从 C0 到 C3 显著增宽（C0：30.59 毫米比 28.54 毫米，P < 0.001；C1：31.31 毫米比 25.98 毫米，P < 0.001；C2：21.56 毫米比 20.40 毫米，P = 0.01；C3：22.45 毫米比 21.23 毫米，P = 0.013），而在 C4 处无统计学意义。从 C1 到 C2，两组的 Area 无差异，但 BI 患者在 C3 和 C4 处增大。
BI 患者 C0 至 C2 的 APD 可能较短，这可能是导致神经压迫的主要原因，需要在矢状面上减压。在病变水平以下，BI 患者的椎管比一般人群大。
3 级。
