Jia Yukun, Peng Zhan, Li Jin, Wang Guangye
The Second School of Clinical Medicine, Southern Medical University, Guangzhou City, China.
Shenzhen Baoan Hospital affiliated to Southern Medical University, Shenzhen City, China.
Can Assoc Radiol J. 2022 Feb;73(1):170-178. doi: 10.1177/08465371211005540. Epub 2021 Apr 19.
The objective was to reconstruct the cervical neural foramen and accurately measure the minimum oblique sagittal area of the neural foramen. Then, a quantitative diagnostic standard for cervical neural foramen stenosis was proposed and its value as an indication for surgery was evaluated.
(1) CT data were used to reconstruct the neural foramen using Mimics software, and the minimum area was measured. (2) The optimal cut-off value was determined using a receiver operating characteristic (ROC) curve. (3) Patients who underwent single-segment surgery were divided into 2 groups according to the cut-off value. Then the postoperative neurological function improvement rate was analyzed to identify any significant difference between the 2 groups.
A total of 1056 neural foramens were measured in 132 patients, of which 495 (46.88%) were diagnosed as radiculopathy by clinical neurological examination. The optimal cut-off value determined by the ROC curve was 25.95 mm (sensitivity 74.1%, specificity 80.9%) and the area under the curve (AUC) was 0.827 (95%CI: 0.803-0.849). There was a significant difference in the neurological function improvement rate between the 2 groups after surgery ( < 0.05). The intraclass correlation coefficient (ICC) was 0.969.
Three-dimensional digital simulation reconstruction of CT data is a good measurement method. The optimal cut-off value determined here not only has a certain reference value for the diagnosis of cervical neural foramen bony stenosis, but also helps to select patients suitable for neural foramen decompression and can be used as a reference for surgical indication.
重建颈椎神经孔并准确测量神经孔的最小斜矢状面积。然后，提出颈椎神经孔狭窄的定量诊断标准并评估其作为手术指征的价值。
（1）使用Mimics软件利用CT数据重建神经孔并测量最小面积。（2）使用受试者工作特征（ROC）曲线确定最佳截断值。（3）将接受单节段手术的患者根据截断值分为2组。然后分析术后神经功能改善率以确定两组之间是否存在显著差异。
共对132例患者的1056个神经孔进行了测量，其中495个（46.88%）经临床神经学检查诊断为神经根病。ROC曲线确定的最佳截断值为25.95 mm（敏感性74.1%，特异性80.9%），曲线下面积（AUC）为0.827（95%CI：0.803 - 0.849）。术后两组神经功能改善率存在显著差异（<0.05）。组内相关系数（ICC）为0.969。
CT数据的三维数字模拟重建是一种良好的测量方法。此处确定的最佳截断值不仅对颈椎神经孔骨性狭窄的诊断有一定参考价值，而且有助于选择适合神经孔减压的患者，可作为手术指征的参考。
