Razzouk Jacob, Case Trevor, Vyhmeister Ethan, Nguyen Kai, Carter Davis, Carter Mei, Sajdak Grant, Kricfalusi Mikayla, Taylor Rachel, Bedward Derran, Shin David, Wycliffe Nathaniel, Ramos Omar, Lipa Shaina A, Bono Christopher M, Cheng Wayne, Danisa Olumide
Loma Linda University School of Medicine, 11175 Campus St, Loma Linda, CA, 92350, USA.
California University of Science and Medicine, 1501 Violet St, Colton, CA, 92324, USA.
Spine J. 2024 May 4. doi: 10.1016/j.spinee.2024.05.001.
Race and sex differences are not consistently reported in the literature. Fundamentally, anatomical differences of cervical neuroforaminal dimensions (CNFD) amongst these groups would be important to know.
To establish normative radiographic morphometric measurements of CNFD and uncover the influence of patient sex, race, and ethnicity while also considering anthropometric characteristics.
Retrospective radiographic morphometric study.
A total of 1,000 patients between 18 and 35 years of age who were free of spinal pathology.
Foraminal height, axial width, and area of cervical neural foramen.
Cervical CTs were reviewed to measure CNFD, defined as follows: foraminal height, axial width, and area. Statistical analyses were performed to assess associations between CNFD, and patient height, weight, sex, race, and ethnicity.
CNFD measurements followed a bimodal distribution pattern moving caudally from C2-T1. Irrespective of disc level, cervical CNFD were as follows: left and right widths of 6.6±1.5 and 6.6±1.5 mm, heights of 9.4±2.4 and 9.4±3.2 mm, and areas of 60.0±19.5 and 60.6±20.7 mm. Left and right foraminal width were highest at C2-C3 and lowest at C3-C4. Left and right foraminal height were highest at C7-T1 and C6-C7, respectively and lowest at C3-C4. Left and right foraminal areas were highest at C2-C3 and lowest at C3-C4. Significant differences were observed for all CNFD measurements across disc levels. CNFD did not vary based on laterality. Significant CNFD differences were observed with respect to patient sex, race, and ethnicity. Male height and area were larger compared to females. In contrast, female foraminal width was larger compared to males. The Asian cohort demonstrated the largest foraminal widths. White and Hispanic patients demonstrated the largest foraminal heights and areas. Black patients demonstrated the smallest foraminal widths, heights, and areas. Patient height and weight were only weakly correlated with CNFD measurements across all levels from C2-T1.
This study describes 36,000 normative measurements of 12,000 foramina from C2-T1. CNFD measurements vary based on disc level, but not laterality. Contrasting left- versus right-sided neuroforamina of the same level may aid in determining the presence of unilateral stenosis. Patient sex, race, and ethnicity are associated with CNFD, while patient anthropometric factors are weakly correlated with CNFD.
种族和性别差异在文献中并未得到一致报道。从根本上说，了解这些群体之间颈椎神经孔尺寸（CNFD）的解剖差异很重要。
建立CNFD的标准影像学形态测量值，揭示患者性别、种族和民族的影响，同时考虑人体测量学特征。
回顾性影像学形态测量研究。
共1000名年龄在18至35岁之间且无脊柱病变的患者。
神经孔高度、轴向宽度和颈椎神经孔面积。
回顾颈椎CT以测量CNFD，定义如下：孔高、轴向宽度和面积。进行统计分析以评估CNFD与患者身高、体重、性别、种族和民族之间的关联。
从C2至T1尾侧方向，CNFD测量值呈双峰分布模式。无论椎间盘节段如何，颈椎CNFD如下：左右宽度分别为6.6±1.5和6.6±1.5毫米，高度分别为9.4±2.4和9.4±3.2毫米，面积分别为60.0±19.5和60.6±20.7平方毫米。左右神经孔宽度在C2-C3处最高，在C3-C4处最低。左右神经孔高度分别在C7-T1和C6-C7处最高，在C3-C4处最低。左右神经孔面积在C2-C3处最高，在C3-C4处最低。在所有椎间盘节段的CNFD测量中均观察到显著差异。CNFD不因左右侧别而有所不同。在患者性别、种族和民族方面观察到CNFD存在显著差异。男性的高度和面积比女性大。相比之下，女性的神经孔宽度比男性大。亚洲人群的神经孔宽度最大。白人和西班牙裔患者的神经孔高度和面积最大。黑人患者的神经孔宽度、高度和面积最小。在从C2至T1的所有节段中，患者身高和体重与CNFD测量值仅呈弱相关。
本研究描述了来自C2至T1的12000个神经孔的36000个标准测量值。CNFD测量值因椎间盘节段而异，但不因左右侧别而不同。对比同一水平的左右神经孔可能有助于确定单侧狭窄的存在。患者性别、种族和民族与CNFD相关，而患者人体测量学因素与CNFD呈弱相关。
