Cui Zhongyi, Wang Hongwei, Sun Yuan, Huang Weibo, Zou Fei, Ma Xiaosheng, Lyu Feizhou, Jiang Jianyuan, Wang Hongli
Department of Orthopaedics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
Asian Spine J. 2024 Feb;18(1):110-117. doi: 10.31616/asj.2023.0234. Epub 2024 Feb 21.
Retrospective clinical trial.
To establish a morphological classification of the cervical spinal canal using its parameters.
Cervical spine computed tomography (CT) data of 200 healthy volunteers in 2 years were analyzed. The morphology of the spinal cord was also analyzed.
The median sagittal diameter and transverse diameter of the spinal canal from C2 to C7 were measured on CT images. The ratio of the median sagittal diameter to the transverse diameter was calculated. Accordingly, the spinal canal shape of each segment was classified into four, and the specific criteria of lunar phase classification were determined through linear discriminant analysis based on the ratio of the median sagittal diameter to the transverse diameter. The inter-rater reliability of the classification was explored using Kappa coefficients. Finally, the morphology of the different segments of the cervical spinal canal in healthy volunteers was revised and compared.
According to the ratio of the median sagittal diameter and the transverse diameter of the cervical spinal canal, the lunar phase classification of the cervical bony spinal canal was determined as follows: full-moon >0.65, 0.55< convex-moon ≤0.65, 0.46≤ quarter-moon ≤0.55, and residual-moon <0.46. The Kappa values of C2-C7 were 0.851, 0.958, 0.823, 0.927, 0.793, and 0.946, and the Kappa value of all C2-C7 segments was 0.854 that mainly presented two forms of full-moon (76.5%) and convex-moon (23.0%). A quarter-moon spinal canal was mainly distributed in C3, C4, C5, and C6; a residual-moon spinal canal was mainly distributed in C4 and C5; and the morphological distribution of C4 and C5 were similar (p>0.05). The frequency of the spinal canal of the residual-moon type was the highest, and the full-moon (6.5%) and residual-moon (7.5%) types of C7 were rare.
The morphological classification of the cervical spinal canal was established to present anatomical variations. The classification showed good inter-rater reliability.
回顾性临床试验。
利用颈椎管参数建立其形态学分类。
分析了2年内200名健康志愿者的颈椎计算机断层扫描（CT）数据。还分析了脊髓的形态。
在CT图像上测量C2至C7椎管的矢状径和横径。计算矢状径与横径的比值。据此，将各节段的椎管形态分为四类，并通过基于矢状径与横径比值的线性判别分析确定月相分类的具体标准。使用Kappa系数探讨分类的评分者间信度。最后，对健康志愿者颈椎管不同节段的形态进行修正和比较。
根据颈椎管矢状径与横径的比值，确定颈椎骨性椎管的月相分类如下：满月型>0.65，凸月型0.55＜凸月型≤0.65，半月型0.46≤半月型≤0.55，残月型＜0.46。C2-C7的Kappa值分别为0.851、0.958、0.823、0.927、0.793和0.946，所有C2-C7节段的Kappa值为0.854，主要呈现满月型（76.5%）和凸月型（23.0%）两种形式。半月型椎管主要分布在C3、C4、C5和C6；残月型椎管主要分布在C4和C5；C4和C5的形态分布相似（p>0.05）。残月型椎管的频率最高，C7的满月型（6.5%）和残月型（7.5%）较少见。
建立了颈椎管形态学分类以呈现解剖变异。该分类显示出良好的评分者间信度。
