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Establishment of parameters for congenital stenosis of the cervical spine: an anatomic descriptive analysis of 1066 cadaveric specimens

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Abstract

Purpose

Congenital cervical stenosis (CCS) occurs when the bony anatomy of the cervical canal is smaller than expected in the general population predisposing an individual to symptomatic neural compression. No studies have defined CCS based on the normal population. The diagnosis is currently made based on clinical impression from radiographic studies. The aim of this study is to establish parameters that are associated with CCS, based on anatomic measurements on a large sample of skeletal specimens.

Methods

From the Hamann-Todd collection at the Cleveland Museum of Natural History, 1,066 skeletal specimens were selected. Digital calipers were used to measure the sagittal canal diameter (SCD), interpedicular distance (IPD), and pedicle length. Canal area at each level was calculated using a geometric formula. A standard distribution was created and values that were 2 SD below mean were considered as congenitally stenotic. An analysis of deviance was performed to identify parameters that were associated with CCS. Regression analysis was used to determine odds ratios (OR) for CCS using these parameters.

Results

CCS was defined at each level as: C3/4 = 1.82 cm2, C4/5 = 1.80 cm2, C5/6 = 1.84 cm2, C6/7 = 1.89 cm2, C7/T1 = 1.88 cm2. Values of SCD < 13 mm and IPD < 22.5 mm were associated with CCS and yielded sensitivities and specificities of 88–100 % at each level. Logistic regression demonstrated a significant association between these parameters and presence of CCS with OR > 18 at each level.

Conclusions

Based on our study of a large population of adult skeletal specimens, we have defined CCS at each level. Values of SCD < 13 mm and IPD < 23 mm are strongly associated with the presence of CCS at all levels.

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References

  1. Gowers WR (1892) Disease of the nervous system, vol 1, 2nd edn. Churchill, London

  2. Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A (2009) Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J 9(7):545–550

    Article  PubMed  Google Scholar 

  3. Shedid D, Benzel EC (2007) Cervical spondylosis anatomy: pathophysiology and biomechanics. Neurosurgery 60(1 Supp1 1):S7–S13

    PubMed  Google Scholar 

  4. Macalister A (1894) The development and varieties of the second cervical vertebra. J Anat Physiol 28:257–268

    PubMed  CAS  Google Scholar 

  5. Cyriax EF (1920) On certain absolute and relative measurements of human vertebrae. J Anat 54(Pt 4):305–308

    PubMed  CAS  Google Scholar 

  6. Francis CC (1955) Dimensions of the cervical vertebrae. Anat Rec 122(4):603–609

    Article  PubMed  CAS  Google Scholar 

  7. Payne EE, Spillane JD (1957) The cervical spine: an anatomico-pathological study of 70 specimens with particular reference to the problem of cervical spondylosis. Brain 80(4):571–596

    Article  PubMed  CAS  Google Scholar 

  8. Gupta SK, Roy RC, Srivastava A (1982) Sagittal diameter of the cervical canal in normal Indian adults. Clin Radiol 33(b):681–685

    Article  PubMed  CAS  Google Scholar 

  9. Kang JD, Figgie MP, Bohlman HH (1994) Sagittal measurements of the cervical spine in subaxial fractures and dislocations: an analysis of two hundred and eighty-eight patients with and without neurological deficits. J Bone Joint Surg Am 76(11):1617–1628

    PubMed  CAS  Google Scholar 

  10. Kim KY, Song B (1975) Radiological measurements of cervical spinal canal in normal Korean adults. J Kor Neurosurg Soc 4(2):239–246

    Google Scholar 

  11. Kothari P, Freeman B, Grevitt M, Kerslake R (2000) Injury to the spinal cord without radiological abnormality (SCIWORA) in adults. J Bone Joint Surg Br 82(7):1034–1037

    Article  PubMed  CAS  Google Scholar 

  12. Chabot MC, Montgomery DM (1995) The pathophysiology of axial and radicular neck pain. Semin Spine Surg 7:2–8

    Google Scholar 

  13. Kumaresan S, Yoganandan N, Pintar FA, Maiman DJ, Goel VK (2001) Contribution of disc degeneration to osteophyte formation in the cervical spine: a biomechanical investigation. J Orthop Res 19(5):977–984

    Article  PubMed  CAS  Google Scholar 

  14. Bernhardt M, Hynes RA, Blume HW, White AA (1993) Cervical spondylotic myelopathy. Bone Joint Surg Am 75(1):119–128

    CAS  Google Scholar 

  15. Vara CS, Thompson GH (2006) A cadaveric examination of pediatric cervical pedicle morphology. Spine 31(10):1107–1112

    Article  PubMed  Google Scholar 

  16. Krejcie RV, Morgan DW (1970) Determining sample size for research activities. Educ Psychol Measur 30:607–610

    Google Scholar 

  17. Lee HM, Kim NH, Kim HJ, Chung IH (1994) Mid-sagittal canal diameter and vertebral body/canal ratio of the cervical spine in Koreans. Yonsei Med J 35(4):446–452

    PubMed  CAS  Google Scholar 

  18. Hashimoto I, Tak YK (1977) The true sagittal diameter of the cervical spinal canal and its diagnostic significance in cervical myelopathy. J Neurosurg 47(6):912–916

    Article  PubMed  CAS  Google Scholar 

  19. Tatarek NE (2005) Variation in the human cervical neural canal. Spine J 5(6):623–631

    Article  PubMed  Google Scholar 

  20. Inoue H, Ohmori K, Takatsu T, Teramoto T, Ishida Y, Suzuki K (1996) Morphological analysis of the cervical spinal canal, dural tube and spinal cord in normal individuals using CT myelography. Neuroradiology 38(2):148–151

    Article  PubMed  CAS  Google Scholar 

  21. Debois V, Herz R, Berghmans D, Hermans B, Herregodts P (1999) Soft cervical disc herniation: influence of cervical spinal canal measurements on development of neurologic symptoms. Spine 24(19):1996–2002

    Article  PubMed  CAS  Google Scholar 

  22. Matsuura P, Waters RL, Adkins RH, Rothman S, Gurbani N, Sie I (1989) Comparison of computerized tomography parameters of the cervical spine in normal control subjects and spinal cord-injured patients. J Bone Joint Surg Am 71(2):183–188

    PubMed  CAS  Google Scholar 

  23. Lee MJ, Cassinelli EH, Riew KD (2007) Prevalence of cervical spine stenosis: anatomic study in cadavers. J Bone Joint Surg Am 89(2):376–380

    Article  PubMed  Google Scholar 

  24. Higo M (1987) Roentgenological study of antero-posterior diameter in developmental canal stenosis of cervical spine. Nihon Seikeigeka Gakkai Zasshi 61(5):455–465

    PubMed  CAS  Google Scholar 

  25. Sasaki T, Kadoya S, Iizuka H (1998) Roentgenological study of the sagittal diameter of the cervical spinal canal in normal adult Japanese. Neurol Med Chir (Tokyo) 38(2):83–88 discussion 88-9

    Article  CAS  Google Scholar 

  26. Bente L, Gerrior SA (2002) Selected food highlights of the 20th century: US food supply series. Fam Econ Nutr Rev 14:43–52

    Google Scholar 

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Authors and Affiliations

  1. Case Western Reserve University, University Hospitals, 13612 Silver Road, Garfield Heights, OH, 44125, USA

    Navkirat S. Bajwa

  2. Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave 1st Floor, New Haven, CT, 06519, USA

    Jason O. Toy

  3. Case Western Reserve University, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Ernest Y. Young

  4. Department of Orthopaedics, Case Western Reserve University, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Nicholas U. Ahn

Authors
  1. Navkirat S. Bajwa
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  2. Jason O. Toy
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  3. Ernest Y. Young
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  4. Nicholas U. Ahn
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Correspondence to Navkirat S. Bajwa.

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Bajwa, N.S., Toy, J.O., Young, E.Y. et al. Establishment of parameters for congenital stenosis of the cervical spine: an anatomic descriptive analysis of 1066 cadaveric specimens. Eur Spine J 21, 2467–2474 (2012). https://doi.org/10.1007/s00586-012-2437-2

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  • DOI: https://doi.org/10.1007/s00586-012-2437-2

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