Virginia Mason Medical Center, Neuroscience Institute, Seattle, WA, 98101, USA.
School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Surg Radiol Anat. 2021 Jun;43(6):873-879. doi: 10.1007/s00276-020-02612-6. Epub 2020 Nov 7.
The purpose of this study is to provide a morphometric description of the bony margins of the interlaminar spaces by level in the cervical spine for guidance of safe posterior cervical surgical dissection and decompression. We also aim to describe the impact of increasing static cervical lordosis on the overlap between the lamina.
Morphometric measurements of the interlaminar space were performed on 100 consecutive cervical spine CT scans of patients ranging in age from 18 to 50 years were selected. Three raters performed measurements of the interlaminar height measured using two techniques (true interlaminar height and surgical interlaminar height), and interlaminar width from C2-C3 to C7-T1.
In total, 100 patients were included. The true interlaminar height was greatest at C2-3, C3-4, C4-5 (5.2 ± 1.4-1.8 mm) and smallest at C6-7 (4.4 ± 1.3 mm). Surgical interlaminar height was greatest at C3-4 (4.2 ± 1.7) and smallest at C6-7 (3.0 ± 1.3 mm). The widest interlaminar space was observed at C3-4 (27.1 ± 2.1 mm) and most narrow at C7-T1 (20.9 ± 2.4 mm). Following multivariate regression, male gender was associated with greater interlaminar widths at each cervical level between C4 and T1 (Table 2). While greater patient height was associated with larger interlaminar height (true and surgical) and width at C2-3 and C4-5, weight was not independently associated with the interlaminar measurements. Increasing C2-C7 lordosis was significantly associated with decreasing true and surgical interlaminar heights at all levels except C7-T1, but was not associated with differences between interlaminar width.
The study provides a morphometric analysis of interlaminar anatomy in the cervical spine. Surgeons can apply this information in their pre-operative plan to safely approach the posterior cervical spine.
本研究旨在通过颈椎水平提供椎间空间骨缘的形态描述，以指导安全的后路颈椎手术解剖和减压。我们还旨在描述静态颈椎前凸增加对椎板重叠的影响。
选择 100 例年龄在 18 至 50 岁之间的连续颈椎 CT 扫描患者的椎间空间进行形态计量测量。三名评估者使用两种技术（真实椎间高度和手术椎间高度）测量了 C2-C3 至 C7-T1 的椎间高度和椎间宽度。
共纳入 100 例患者。真实椎间高度在 C2-3、C3-4、C4-5 最大（5.2±1.4-1.8mm），在 C6-7 最小（4.4±1.3mm）。手术椎间高度在 C3-4 最大（4.2±1.7mm），在 C6-7 最小（3.0±1.3mm）。椎间空间最宽见于 C3-4（27.1±2.1mm），最窄见于 C7-T1（20.9±2.4mm）。多元回归后，男性在 C4 至 T1 各颈椎水平的椎间宽度较大（表 2）。虽然患者身高越高，椎间高度（真实和手术）和 C2-3、C4-5 的椎间宽度越大，但体重与椎间测量值无独立相关性。C2-C7 前凸增加与所有水平的真实和手术椎间高度降低显著相关，但与椎间宽度无差异。
本研究对颈椎椎间空间的解剖结构进行了形态计量分析。外科医生可以在术前计划中应用这些信息，以安全地接近颈椎后路。
