Srivastava Abhishek, Nanda Geetanjali, Mahajan Rajat, Nanda Ankur, Batra Sahil, Mishra Nirajana, Pandita Naveen, Chhabra Harvinder Singh
Department of Spine Services, Primus Hospital, New Delhi, India.
Department of Radiodiagnosis, Mahajan Imaging Centre, New Delhi, India.
Asian Spine J. 2019 Feb;13(1):7-12. doi: 10.31616/asj.2018.0110. Epub 2018 Oct 18.
Observational study of computed tomography (CT) data.
We performed a CT-based radiographic analysis of sub-axial cervical lamina in the Indian population to assess the feasibility of laminar screws.
Morphometric studies have been performed for populations of various ethnic groups, but none exist for Indian populations.
Cervical spine CT scans of 50 adults with a minimum slice thickness of <2 mm (0.5-2 mm) were obtained from the database of a single center in northern India. Measurements (e.g., length, thickness, and height) were taken in millimeters along the axial, coronal, and sagittal planes. Three measurements were made to assess laminar anatomy, namely, the translaminar/screw length, laminar thickness, and sagittal laminar height.
The final sample comprised 500 laminae in 50 patients, resulting in 1,500 measurements. The mean translaminar lengths of the C3, C4, C5, C6, and C7 laminae were 19.48 mm, 19.60 mm, 19.61 mm, 20.49 mm, and 22.85 mm, respectively. The mean thick- , 19.60 , 19.60 mm, 19.61 mm, 20.49 mm, and 22.85 mm, respectively. The mean thick- mm, 19.61 mm, 20.49 mm, and 22.85 mm, respectively. The mean thick- , 19.61 , 19.61 mm, 20.49 mm, and 22.85 mm, respectively. The mean thick- mm, 20.49 mm, and 22.85 mm, respectively. The mean thick- , 20.49 , 20.49 mm, and 22.85 mm, respectively. The mean thick- mm, and 22.85 mm, respectively. The mean thick- , and 22.85 mm, respectively. The mean thick , and 22.85 mm, respectively. The mean thicknesses of these cervical laminae were 3.12 mm, 2.62 mm, 2.56 mm, 3.47 mm, and 5.20 mm, respectively. The mean sagittal heights of these laminae were 9.38 mm, 9.80 mm, 10.12 mm, 11.31 mm, and 13.84 mm, respectively. Except for the C7 vertebrae, all other levels had a success rate of <10% in the Indian population using the criteria of a laminar height of at least 9 mm and thickness of 4.5 mm. Limited success was achieved at the C5, C6, and C3 levels.
To the best of our knowledge, the present study is the only series on the feasibility of laminar screws in the sub-axial cervical spine in the Indian population. We found that Indian patients have smaller anatomical dimensions and thus, are not suitable for laminar screws in the sub-axial cervical spine, barring C7, which is contrary to findings for populations in western and south Asian countries.
对计算机断层扫描（CT）数据的观察性研究。
我们对印度人群的颈椎下椎板进行了基于CT的影像学分析，以评估椎板螺钉的可行性。
已针对不同种族人群开展了形态测量学研究，但尚无针对印度人群的此类研究。
从印度北部一个单一中心的数据库中获取了50名成年人的颈椎CT扫描图像，最小层厚<2毫米（0.5 - 2毫米）。沿着轴向、冠状面和矢状面以毫米为单位进行测量（如长度、厚度和高度）。进行了三项测量以评估椎板解剖结构，即跨椎板/螺钉长度、椎板厚度和矢状椎板高度。
最终样本包括50名患者的500个椎板，共进行了1500次测量。C3、C4、C5、C6和C7椎板的平均跨椎板长度分别为19.48毫米、19.60毫米、19.61毫米、20.49毫米和22.85毫米。这些颈椎椎板的平均厚度分别为3.12毫米、2.62毫米、2.56毫米、3.47毫米和5.20毫米。这些椎板的平均矢状高度分别为9.38毫米、9.80毫米、10.12毫米、11.31毫米和13.84毫米。除C7椎体外，按照椎板高度至少9毫米且厚度4.5毫米的标准，印度人群中其他所有节段的成功率均<10%。C5、C6和C3节段取得了有限的成功。
据我们所知，本研究是关于印度人群颈椎下椎板螺钉可行性的唯一系列研究。我们发现，印度患者的解剖尺寸较小，因此，除C7外，不适合在颈椎下椎板使用椎板螺钉，这与西方和南亚国家人群的研究结果相反。
