颈前路椎间盘切除和融合过程中部分未缝合过程切除的术前放射学模拟,以实现充分的椎板减压和预防椎动脉损伤。

IF 2.3 Q2 ORTHOPEDICS
Asian Spine Journal Pub Date : 2023-12-01 Epub Date: 2023-11-10 DOI:10.31616/asj.2023.0087
Jae Jun Yang, Ho-Jun Kim, Jin Bog Lee, Sehan Park
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引用次数: 0

摘要

研究设计:回顾性放射学研究。目的:本研究旨在证明钩突后段部分切除联合颈前路椎间盘切除融合术(ACDF)的正确切除轨迹,并评估椎间孔狭窄或钩突变性是否会增加椎动脉(VA)损伤的风险。文献综述:适当的切除轨迹可以导致充分的减压并避免椎动脉损伤尚不清楚。方法:我们回顾性分析了接受颈部磁共振成像和计算机断层扫描血管造影术进行术前ACDF评估的患者。根据椎间孔狭窄的存在对节段进行分类。测量钩突的高度、厚度、前后长度、从钩突到VA的水平距离以及从钩突基线到VA的垂直距离。测量钩前边缘与切除轨迹(UAM至RT)之间的距离。结果:在101例接受ACDF的患者中(163节,平均年龄56.3±12.2),没有VA损伤或根损伤。有椎间孔狭窄的椎间孔的钩突前后长度明显较长,而钩突高度、厚度以及钩突与VA之间的距离与椎间孔狭窄无显著相关性。钩状核变性的放射学参数没有显著差异。对于C3-C4、C4-C5、C5-C6和C6-C7,充分减压的UAM至RT距离分别为1.6±1.4 mm(范围0-4.8 mm)、3.4±1.7 mm(范围0-7.1 mm)、4.0±1.7毫米(范围0-9.0 mm)和4.5±1.2 mm(范围2.5-7.5 mm)。结论:为了进行充分的神经孔减压,应切除前后平面上一半以上的钩突。羊膜前狭窄或钩状变性不会改变钩突和VA的相对解剖结构,也不会影响VA损伤的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative Radiographic Simulation for Partial Uncinate Process Resection during Anterior Cervical Discectomy and Fusion to Achieve Adequate Foraminal Decompression and Prevention of Vertebral Artery Injury.

Study design: Retrospective radiographic study.

Purpose: This study aims to demonstrate the proper resection trajectory of a partial posterior uncinate process resection combined with anterior cervical discectomy and fusion (ACDF) and evaluate whether foraminal stenosis or uncinate process degeneration increases the risk of vertebral artery (VA) injury.

Overview of literature: Appropriate resection trajectory that could result in sufficient decompression and avoid vertebral artery injury is yet unknown.

Methods: We retrospectively reviewed patients who underwent cervical magnetic resonance imaging and computed tomography angiography for preoperative ACDF evaluation. The segments were classified according to the presence of foraminal stenosis. The height, thickness, anteroposterior length, horizontal distance from the uncinate process to the VA, and vertical distance from the uncinate process baseline to the VA of the uncinate process were measured. The distance between the uncinate anterior margin and the resection trajectory (UAM-to-RT) was measured.

Results: There were no VA injuries or root injuries among the 101 patients who underwent ACDF (163 segments, mean age of 56.3±12.2). Uncinate anteroposterior length was considerably longer in foramens with foraminal stenosis, whereas uncinate process height, thickness, and distance between the uncinate process and VA were not significantly associated with foraminal stenosis. There were no significant differences in radiographic parameters based on uncinate degeneration. The UAM-to-RT distances for adequate decompression were 1.6±1.4 mm (range, 0-4.8 mm), 3.4±1.7 mm (range, 0-7.1 mm), 4.0±1.7 mm (range, 0-9.0 mm), and 4.5±1.2 mm (range, 2.5-7.5 mm) for C3-C4, C4-C5, C5-C6, and C6-C7, respectively.

Conclusions: More than half of the uncinate process in the anteroposterior plane should be removed for adequate neural foramen decompression. Foraminal stenosis or uncinate degeneration did not alter the relative anatomy of the uncinate process and the VA and did not impact VA injury risk.

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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
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