Department of Orthopaedic Surgery, Christchurch Hospital, Christchurch, New Zealand.
Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand.
ANZ J Surg. 2024 Nov;94(11):1963-1970. doi: 10.1111/ans.19186. Epub 2024 Aug 10.
Reduced spinal canal anteroposterior (AP) diameter and AP-transverse diameter ratio have been linked to the development of spinal cord injury and myelopathy. Previously unpublished data has suggested Maori and Pacifica individuals may have narrower cervical spine canals than their NZ European counterparts.
We evaluate the existence of potential differences in dimensions of the sub-axial cervical spine canal between New Zealand European, Māori and Polynesian individuals.
A computed tomography (CT) analysis of 645 intact adult sub-axial cervical vertebrae from 129 patients.
A total of 645 human sub-axial (C3-C7) cervical vertebrae were analysed radiographically, using 1 mm resolution CT scans to measure AP diameter, transverse diameter and AP:transverse ratio. CT data were obtained from normal trauma scans demonstrating no acute pathology. CT data was reformatted in digital software allowing multi-planar reconstruction (MPR) to increase accuracy of measurements. Statistical analysis was performed using analysis of variance (ANOVA).
A total of 245 vertebrae were from Māori individuals, 245 from NZ European and 155 from Polynesians. There were 455 male vertebrae and 215 female vertebrae. Statistically significant differences were found in AP canal diameter between all ethnic groups, at all spinal levels. The average cervical spine canal was around 2.5 mm narrower in Polynesians and around 1.5 mm narrower in Māori than NZ Europeans. No differences in Transverse canal diameter were observed, however statistically significant differences were found in the AP:transverse ratio at all spinal levels.
Our study, utilizing a normal patient cohort, confirms differences in canal dimensions between ethnic groups.
Ethnic variation in cervical canal dimensions as herein described, must be considered when defining and diagnosing congenital stenosis. Neglecting to account for these differences may lead to misdiagnosis of congenital stenosis in normal individuals in certain ethnic groups.
椎管前后径（AP）和 AP-横径比的减小与脊髓损伤和脊髓病的发展有关。以前未公布的数据表明，毛利人和太平洋岛屿人可能比新西兰欧洲人有更窄的颈椎管。
我们评估新西兰欧洲人、毛利人和波利尼西亚人下颈椎管尺寸是否存在潜在差异。
对 129 例患者的 645 个完整成人下颈椎（C3-C7）的计算机断层扫描（CT）分析。
使用 1mm 分辨率的 CT 扫描对总共 645 个人的下颈椎（C3-C7）进行放射照相分析，以测量 AP 直径、横径和 AP：横径比。CT 数据是从无急性病理的正常创伤扫描中获得的。将 CT 数据转换为数字软件，允许进行多平面重建（MPR），以提高测量的准确性。使用方差分析（ANOVA）进行统计分析。
245 个椎体来自毛利人，245 个来自新西兰欧洲人，155 个来自波利尼西亚人。有 455 个男性椎体和 215 个女性椎体。在所有种族群体中，所有脊柱水平的 AP 管直径均存在统计学显著差异。波利尼西亚人的平均颈椎管狭窄约 2.5mm，毛利人比新西兰欧洲人狭窄约 1.5mm。在横径方面没有观察到差异，但是在所有脊柱水平上，AP：横径比存在统计学显著差异。
我们的研究利用正常患者队列，证实了种族之间管腔尺寸的差异。
正如本文所述，颈椎管尺寸的种族差异在定义和诊断先天性狭窄时必须考虑。如果忽略这些差异，可能会导致某些种族的正常个体中先天性狭窄的误诊。
