Malla Hridayesh Pratap, Kim Sung Bum, Won Jun Sung, Choi Man Kyu
Kathmandu Model Hospital Pradashani Marg, Kathmandu, Nepal.
Department of Neurosurgery, Kyung Hee University Hospital, Seoul, Korea.
Neurospine. 2018 Jun;15(2):163-168. doi: 10.14245/ns.1836004.022. Epub 2018 Jun 19.
The purpose of this study was to provide anatomical data on the dimensions and location of the subaxial transverse foramen (TF) in relation to surgical landmarks routinely used during anterior cervical procedures.
A total of 116 patients who underwent preoperative computed tomography (CT) evaluations for degenerative cervical disease were enrolled. Axial and coronal CT images of the cervical vertebrae from C3 to C6 were analyzed to measure interforaminal distance, the TF distance from the anterior and posterior vertebral body margin, TF dimensions, and the TF medial margin from the tip and medial margin of the uncus. Comparative and correlative analyses were also performed according to age, body mass index (BMI), and sex.
All measurement values in male patients were larger than those in their female counterparts. The interforaminal distance gradually increased from C3 to C6. The distance of the TF medial margin from the tip of the uncus was found be above approximately 3 mm in all vertebrae except C6. Correlation analysis revealed that age had a significant negative relationship with the transverse diameter of TF. In contrast, BMI had a significant positive correlation with interforaminal distance. Moreover, the distances of the TF medial margin from the tip and medial margin of the uncus showed strong negative correlations with age.
Useful morphometric data were obtained that may help the operating surgeon to avoid vertebral artery injury. The safe distance from the tip of the uncus to the TF medial margin was found to be approximately 3 mm, and this distance should not be violated during lateral decompression. In addition, this value may decrease with age.
本研究旨在提供关于下颈椎横突孔（TF）的尺寸和位置的解剖学数据，这些数据与颈椎前路手术中常规使用的手术标志相关。
共纳入116例因颈椎退行性疾病接受术前计算机断层扫描（CT）评估的患者。分析C3至C6颈椎的轴向和冠状位CT图像，以测量椎间孔间距、TF与椎体前后缘的距离、TF尺寸以及TF内侧缘与钩突尖端和内侧缘的距离。还根据年龄、体重指数（BMI）和性别进行了比较和相关性分析。
男性患者的所有测量值均大于女性患者。椎间孔间距从C3到C6逐渐增加。除C6外，在所有椎体中，TF内侧缘与钩突尖端的距离均在约3 mm以上。相关性分析显示，年龄与TF的横径呈显著负相关。相反，BMI与椎间孔间距呈显著正相关。此外，TF内侧缘与钩突尖端和内侧缘的距离与年龄呈强烈负相关。
获得了有用的形态学数据，可能有助于手术医生避免椎动脉损伤。发现钩突尖端到TF内侧缘的安全距离约为3 mm，在进行侧方减压时不应侵犯此距离。此外，该值可能随年龄增长而减小。
