Tomodensitometric Bone Anatomy of The Intervertebral Foramen of The Lower Cervical Spine: Measurements and Comparison of Foraminal Volume in Healthy Individuals and Patients Suffering from Cervicobrachial Neuralgia Due to Foraminal Stenosis.

Abstract Purpose Degenerative foraminal stenosis of the cervical spine can lead to cervicobrachial neuralgias. Computed tomography (CT)-scan assists in the diagnosis and evaluation of foraminal stenosis. The main objective of this study is to determine the bony dimensions of the cervical intervertebral foramen and to identify which foraminal measurements are most affected by degenerative disorders of the cervical spine. These data could be applied to the surgical treatment of this pathology, helping surgeons to focus on specific areas during decompression procedures. Methods A descriptive study was conducted between two groups: an asymptomatic one (young people with no evidence of degenerative cervical spine disorders) and a symptomatic one (experiencing cervicobrachial neuralgia due to degenerative foraminal stenosis). Using CT scans, we determined a method allowing measurements of the following foraminal dimensions: foraminal height (FH), foraminal length (FL), foraminal width in its lateral part ((UWPP, MWPP and IWPP (respectively Upper, Medial and Inferior Width of Pedicle Part)) and medial part (UWMP, MWMP and IWMP (respectively Upper, Medial and Inferior Width of Medial Part)), and disk height (DH). Foraminal volume (FV) was calculated considering the above data. Mean volumes were measured in the asymptomatic group and compared to the values obtained in the symptomatic group. Results Both groups were made up of 10 patients, and a total of 50 intervertebral discs (100 intervertebral foramina) were analyzed in each group. Comparison of C4C5, C5C6 and C6C7 levels between both groups showed several significant decreases in foraminal dimensions (p< 0,05) as well as in foraminal volume (p <0.001) in the symptomatic group. The most affected dimensions were UWPP, MWPP, UWMP, MWMP and FV. The most stenotic foraminal areas were the top of the uncus and the posterior edge of the lower plate of the overlying vertebra. Conclusion Using a new protocol for measuring foraminal volume, the present study refines the current knowledge of the normal and pathological anatomy of the lower cervical spine and allows us to understand the foraminal sites most affected by degenerative stenosis. Those findings can be applied to foraminal stenosis surgeries. According to our results, decompression of the foramen in regard of both uncus osteophytic spurs and inferior plate of the overlying vertebra might be an important step for nerve roots release.

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Analysis of the uncinate processes of the cervical spine: an anatomical study

Journal of Neurosurgery Spine ◽

10.3171/2011.12.spine11541 ◽

2012 ◽

Vol 16 (4) ◽

pp. 402-407 ◽

Cited By ~ 18

Author(s):

R. Shane Tubbs ◽

Olivia J. Rompala ◽

Ketan Verma ◽

Martin M. Mortazavi ◽

Brion Benninger ◽

...

Keyword(s):

Cervical Spine ◽

Anatomical Study ◽

Axial Rotation ◽

Intervertebral Discs ◽

Uncinate Process ◽

Surgical Approaches ◽

Intervertebral Foramen ◽

Facet Joints ◽

Vertebral Level ◽

Arthritic Changes

Object Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this region's morphological features. Methods Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. Results The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. Conclusions A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.

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Stress Changes in Intervertebral Discs of the Cervical Spine After Arthrodesis

Advances in Bioengineering ◽

10.1115/imece2002-32627 ◽

2002 ◽

Cited By ~ 1

Author(s):

Abraham Tchako ◽

Ali Sadegh

Keyword(s):

Cervical Spine ◽

Intervertebral Discs ◽

Measurement Tool ◽

Fe Model ◽

Lower Cervical Spine ◽

Stress Changes ◽

Spine Model ◽

Vertebral Bodies ◽

Cervical Spine Fusion ◽

Geometric Measurement

An improved and detailed 3D FE model of human cervical spine model was created using digitized geometric measurement tool. The vertebral bodies of the model were fused at three locations. The unfused and the fused models were physiologically loaded and the changes in stresses in intervertebral discs were compared. A moment of 1.5 Nm was used in combination with a 50 N compressive preload. The results showed that the lower cervical spine fusion induces the most stress changes in the neighboring discs.

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A survival analysis of surgically treated incidental low-grade glioma patients

Scientific Reports ◽

10.1038/s41598-021-88023-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lingcheng Zeng ◽

Qi Mei ◽

Hua Li ◽

Changshu Ke ◽

Jiasheng Yu ◽

...

Keyword(s):

Progression Free Survival ◽

Low Grade Glioma ◽

Low Grade ◽

Total Resection ◽

Surgical Timing ◽

Asymptomatic Group ◽

Free Survival ◽

Symptomatic Group ◽

Significant Difference ◽

Asymptomatic Phase

AbstractTo evaluate the surgical effect on survival in patients with incidental low-grade glioma (LGG) through comparison between asymptomatic and symptomatic patients. The medical records of surgically treated adult cerebral incidental LGG (iLGG) patients in our department between January 2008 and December 2015 were retrospectively reviewed. The survival of patients was calculated starting from the initial imaging diagnosis. Factors related to progression-free survival (PFS), overall survival (OS) and malignant progression-free survival (MPFS) were statistically analyzed. Seventy-five iLGG patients underwent surgery: 49 in the asymptomatic group, who underwent surgery in the asymptomatic period, and 26 in the symptomatic group, who underwent surgery after the tumor had grown and the patients had developed tumor-related symptoms. Significantly more tumors were initially located adjacent to the functional area in the symptomatic group than in the asymptomatic group (P < 0.05), but there was no significant difference in the total resection rate between the two groups. The incidence of postoperative complications (15.4%) and postoperative epilepsy (23.1%) was higher in the symptomatic group than in the asymptomatic group (4.1% and 10.2%, respectively). Multivariate analysis showed that surgical timing, namely, surgery performed before or after symptom occurrence, had no significant effect on PFS, OS or MPFS, while total resection significantly prolonged PFS, OS and MPFS, and the pathology of oligodendroglioma was positively correlated with PFS and OS (P < 0.05). Surgical timing for iLGGs should facilitate total resection. If total resection can be achieved, even after symptom occurrence, patients can achieve comparable survival benefits to those treated with surgery in the asymptomatic phase.

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Discectomies of the lower cervical spine using interbody biopolymer (B.O.P.) implants

Acta Neurochirurgica ◽

10.1007/bf01456164 ◽

1989 ◽

Vol 96 (3-4) ◽

pp. 88-93 ◽

Cited By ~ 23

Author(s):

G. Lozes ◽

A. Fawaz ◽

A. Cama ◽

I. Krivosic ◽

P. Devos ◽

...

Keyword(s):

Cervical Spine ◽

Lower Cervical Spine

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Lower Cervical Spine Injury

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2011.24.1.100 ◽

2011 ◽

Vol 24 (1) ◽

pp. 100 ◽

Cited By ~ 2

Author(s):

Jae-Sung Ahn

Keyword(s):

Cervical Spine ◽

Cervical Spine Injury ◽

Spine Injury ◽

Lower Cervical Spine

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New Possible Surgical Approaches for the Submammary Adipofascial Flap Based on Its Arterial Supply

Anatomy Research International ◽

10.1155/2016/7696010 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10

Author(s):

Ehab M. Elzawawy ◽

Melad N. Kelada ◽

Ahmed F. Al Karmouty

Keyword(s):

Breast Implants ◽

Partial Mastectomy ◽

Surgical Approaches ◽

Lateral Part ◽

Medial Part ◽

Fat Necrosis ◽

Adipofascial Flap ◽

Multiple Origins ◽

Inferior Portion ◽

Perforator Vessels

Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

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