Jiang Jianfeng, Ma Jun, Yang Maoyu, Han Yaozheng, Su Lintao, Lei Changyu, Ge Chenguang, Kang Hui
Medical College, Wuhan University of Science and Technology, Wuhan Hubei, 430065, P. R. China.
Department of Orthopedics, General Hospital of Central Theater Command of Chinese PLA, Wuhan Hubei, 430070, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Mar 15;39(3):332-340. doi: 10.7507/1002-1892.202412052.
To explore the anatomical parameters of the cervical uncinate process "inflection point" through cervical CT angiography (CTA) and MRI measurements, offering a reliable and safe anatomical landmark for anterior cervical decompression surgery.
A retrospective analysis was conducted on the cervical CTA and MRI imaging data of normal adults who met the selection criteria between January 2020 and January 2024. The CTA dataset included 326 cases, with 200 males and 126 females, aged 22-55 years (mean, 46.7 years). The MRI dataset included 300 cases, with 200 males and 100 females, aged 18-55 years (mean, 43.7 years). Based on the CTA data, three-dimensional models of C -C were constructed, and the following measurements were obtained from the superior view: uncinate process "inflection point" to vertebral artery distance (UIVD), uncinate process tip to vertebral artery distance (UTVD), uncinate process "inflection point" to "inflection point" distance (UID), uncinate process long-axis to sagittal angle (ULSA), and uncinate process "inflection point" to transverse foramen-sagittal angle (UITSA). From the anterior view, the anterior uncinate process to sagittal angle (AUSA) was measured. From the posterior view, the posterior uncinate process to sagittal angle (PUSA) was measured. Based on the MRI data, uncinate process "inflection point" to dural sac distance (UIDD) and dural sac width (DSW) were measured. The trends in measurement parameters of C -C were observed, and the differences in measurement parameters between genders and between the left and right sides of the same segment were compared, as well as the difference in UID and DSW within the same segment was compared.
The measurement parameters from C to C in the CTA data showed a general increasing trend, with no significant difference between the left and right sides within the same segment ( >0.05). The UIVD, UTVD, and UID were greater in males than in females, with significant differences observed in the UIVD and UTVD at C and C and UID at C , C , and C ( <0.05). The MRI measured DSW showed a general increasing trend from C to C , and the DSW at C was greater in females than in males, with a significant difference ( <0.05). The UIDD showed a gradual decreasing trend, with the smallest value at C . There was no significant difference between males and females or between the left and right sides within the same segment ( >0.05). The UID was greater than the DSW at C -C , and the differences were significant ( <0.05).
The uncinate process "inflection point" is a constant anatomical structure located at the anteromedial aspect of the uncinate process tip and laterally to the dural sac. It maintains a certain safe distance from the vertebral artery. As a decompression landmark in anterior cervical spine surgery, it not only ensures surgical safety but also guarantees complete decompression.
通过颈椎CT血管造影（CTA）和MRI测量，探讨颈椎钩突“拐点”的解剖学参数，为颈椎前路减压手术提供可靠、安全的解剖学标志。
回顾性分析2020年1月至2024年1月期间符合入选标准的正常成年人的颈椎CTA和MRI影像资料。CTA数据集包括326例，其中男性200例，女性126例，年龄22 - 55岁（平均46.7岁）。MRI数据集包括300例，其中男性200例，女性100例，年龄18 - 55岁（平均43.7岁）。基于CTA数据，构建C - C的三维模型，从上面观获得以下测量值：钩突“拐点”至椎动脉距离（UIVD）、钩突尖至椎动脉距离（UTVD）、钩突“拐点”至“拐点”距离（UID）、钩突长轴与矢状面夹角（ULSA）、钩突“拐点”至横突孔矢状面夹角（UITSA）。从前面观，测量前钩突与矢状面夹角（AUSA）。从后面观，测量后钩突与矢状面夹角（PUSA）。基于MRI数据，测量钩突“拐点”至硬脊膜囊距离（UIDD）和硬脊膜囊宽度（DSW）。观察C - C测量参数的变化趋势，比较不同性别及同一节段左右两侧测量参数的差异，以及同一节段UID和DSW的差异。
CTA数据中C至C的测量参数总体呈上升趋势，同一节段左右两侧差异无统计学意义（>0.05）。UIVD、UTVD和UID男性大于女性，C和C节段的UIVD和UTVD以及C、C和C节段的UID差异有统计学意义（<0.05）。MRI测量的DSW从C至C总体呈上升趋势，C节段女性的DSW大于男性，差异有统计学意义（<0.05）。UIDD呈逐渐下降趋势，C节段最小。同一节段男女之间及左右两侧差异无统计学意义（>0.05）。C - C节段UID大于DSW，差异有统计学意义（<0.05）。
钩突“拐点”是位于钩突尖前内侧、硬脊膜囊外侧的恒定解剖结构，与椎动脉保持一定安全距离。作为颈椎前路手术的减压标志，它不仅能确保手术安全，还能保证彻底减压。
