DOI QR코드

DOI QR Code

Morphometrical Study of Uncinate Processes and Vertebral Body of Cervical Spine

  • Lee, Tae-Hoon (Department of Neurosurgery, 21st Century Hospital) ;
  • Kim, Sang-Jin (Department of Neurosurgery, Ewha Womans University School of Medicine, Mokdong Hospital) ;
  • Chung, In-Hyuk (Department of Anatomy, Yonsei University School of Medicine)
  • Received : 2012.01.11
  • Accepted : 2012.05.15
  • Published : 2012.05.28

Abstract

Objective : The anatomical knowledge is the most important and has a direct link with success of operation in cervical spine surgery. The authors measured various cervical parameters in cadaveric dry bones and compared with previous reported results. Methods : We made 255 dry bones age from 19 to 72 years (mean, 42.3 years) that were obtained from 51 subjects in 100 subjects who donated their bodies. All measurements from C3-C7 levels were made using digital vernier calipers, standard goniometer, and self-made fix tool for two different cervical axes (canal and disc setting). We classified into 4 groups (uncinate process, vertebral body, lamina, and pedicle) and measured independently by two neurosurgeons for 28 parameters. Results : We analyzed 23970 measurements by mean value and standard deviations. In comparing with previous literatures, there are some different results. The mean values for uncinate process (UP) width ranged from 5.5 mm at C4 and 5 to 6.3 mm at C3 and C7 in men. Also, in women, the mean values for UP width ranged from 5.5 mm at C5 to 6.3 mm at C7. C7 was widest and C5 was most narrow than other levels. The antero-posterior length of UP tended to increase gradually from C3 to C6. The tip way, tip distance, and base distance of UP also showed increasing pattern from C3 to C7. Conclusion : These measurements can provide the spinal surgeons with a starting point to address bony architectures surrounding targeted soft tissues for safeguard against unintended damages during cervical operation.

Keywords

References

  1. Clausen JD, Goel VK, Traynelis VC, Scifert J : Uncinate processes and Luschka joints influence the biomechanics of the cervical spine : quantification using a finite element model of the C5-C6 segment. J Orthop Res 15 : 342-347, 1997 https://doi.org/10.1002/jor.1100150305
  2. Ebraheim NA, Lu J, Biyani A, Brown JA, Yeasting RA : Anatomic considerations for uncovertebral involvement in cervical spondylosis. Clin Orthop Relat Res : 200-206, 1997
  3. Ebraheim NA, Lu J, Brown JA, Biyani A, Yeasting RA : Vulnerability of vertebral artery in anterolateral decompression for cervical spondylosis. Clin Orthop Relat Res : 146-151, 1996
  4. Ebraheim NA, Xu R, Bhatti RA, Yeasting RA : The projection of the cervical disc and uncinate process on the posterior aspect of the cervical spine. Surg Neurol 51 : 363-367, 1999 https://doi.org/10.1016/S0090-3019(98)00116-5
  5. Ebraheim NA, Xu R, Lin D, Haman S, Yeasting RA : Quantitative anatomy of the transverse foramen and pedicle of the axis. J Spinal Disord 11 : 521-525, 1998
  6. Frykholm R : Lower cervical vertebrae and intervertebral discs; surgical anatomy and pathology. Acta Chir Scand 101 : 345-359, 1951
  7. Lu J, Ebraheim NA, Yang H, Skie M, Yeasting RA : Cervical uncinate process : an anatomic study for anterior decompression of the cervical spine. Surg Radiol Anat 20 : 249-252, 1998 https://doi.org/10.1007/BF01628483
  8. Marchiori DM, Henderson CN : A cross-sectional study correlating cervical radiographic degenerative findings to pain and disability. Spine (Phila Pa 1976) 21 : 2747-2751, 1996 https://doi.org/10.1097/00007632-199612010-00007
  9. Milne N : The role of zygapophysial joint orientation and uncinate processes in controlling motion in the cervical spine. J Anat 178 : 189-201, 1991
  10. Pait TG, Killefer JA, Arnautovic KI : Surgical anatomy of the anterior cervical spine : the disc space, vertebral artery, and associated bony structures. Neurosurgery 39 : 769-776, 1996 https://doi.org/10.1097/00006123-199610000-00026
  11. Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K : Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine (Phila Pa 1976) 16 : 861-869, 1991 https://doi.org/10.1097/00007632-199108000-00001
  12. Payne EE, Spillane JD : The cervical spine; an anatomico-pathological study of 70 specimens (using a special technique) with particular reference to the problem of cervical spondylosis. Brain 80 : 571-596, 1957 https://doi.org/10.1093/brain/80.4.571
  13. Saringer W, Nöbauer I, Reddy M, Tschabitscher M, Horaczek A : Microsurgical anterior cervical foraminotomy (uncoforaminotomy) for unilateral radiculopathy : clinical results of a new technique. Acta Neurochir (Wien) 144 : 685-694, 2002
  14. 14. Saringer WF, Reddy B, Nöbauer-Huhmann I, Regatschnig R, Reddy M, Tschabitscher M, et al. : Endoscopic anterior cervical foraminotomy for unilateral radiculopathy : anatomical morphometric analysis and preliminary clinical experience. J Neurosurg 98 : 171-180, 2003
  15. Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M : Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 75 : 410-415, 1993
  16. TaScioglu AO, Attar A, TaScioglu B : Microsurgical anterior cervical foraminotomy (uncinatectomy) for cervical disc herniation. Report of three cases. J Neurosurg 94 : 121-125, 2001
  17. Ugur HC, Uz A, Attar A, Tekdemir I, Egemen N, Elhan A : Anatomical projection of the cervical uncinate process in ventral, ventrolateral, and posterior decompressive surgery. J Neurosurg 93 : 248-251, 2000
  18. White AA, Panjabi MM : Clinical biomechanics of the spine, ed 2. Philadelphia : Lippincott, 1990, pp722
  19. Yilmazlar S, Ikiz I, Kocaeli H, Tekdemir I, Adim SB : Details of fibroligamentous structures in the cervical unco-vertebral region : an obscure corner. Surg Radiol Anat 25 : 50-53, 2003 https://doi.org/10.1007/s00276-002-0087-5
  20. Yilmazlar S, Kocaeli H, Uz A, Tekdemir I : Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region. Clin Anat 16 : 404-410, 2003 https://doi.org/10.1002/ca.10158

Cited by

  1. Morphometric evaluation of the uncinate process and its importance in surgical approaches to the cervical spine: a cadaveric study vol.57, pp.10, 2016, https://doi.org/10.11622/smedj.2015193
  2. Risk assessment of vertebral artery injury in anterior controllable antedisplacement and fusion (ACAF) surgery: a cadaveric and radiologic study vol.28, pp.10, 2019, https://doi.org/10.1007/s00586-019-06111-0