Neural foraminal dimensions are considered important in nerve root compression and development of cervical radiculopathy, but baseline data regarding their range during normal motion are not available. An in vivo study of cervical foraminal motion was conducted to characterize normal 3D dynamic foraminal dimensions during physiological neck motion and compare between different tasks and intervertebral segments.
Biplane X-ray imaging and computed tomography-based markerless tracking were used to measure foraminal height (FH) and width (FW) from five asymptomatic subjects during neck axial rotation and extension. FH and FW were quantified as the minimum (SI.Min and AP.Min), range (SI.Range and AP.Range), and median (SI.Med and AP.Med) of superoinferior (SI) and anteroposterior (AP) dimensions for each trial and as the coefficient of variation of these variables from three trials (SI.Med.CV and AP.Med.CV, SI.Range.CV and AP.Range.CV) at C3-4 through C6-7 levels for each subject. Differences were analyzed using mixed model ANOVA.
AP.Range and AP.Med.CV were greater (P < 0.0001) while AP.Min and AP.Range.CV were smaller (P < 0.0006 and P < 0.0005) during neck extension than rotation. SI.Range and SI.Med.CV were greater for extension than rotation at C5-6 (P < 0.002 and P < 0.03), whereas SI.Med.CV was greater for rotation than extension at C3-4 (P < 0.03). AP.Range (P < 0.02), AP.Med.CV (P < 0.05), SI.Range (P < 0.0004), and SI.Med.CV (P < 0.02) were different between cervical levels, the latter two being during extension only.
Patterns of FH and FW during normal motion are different between tasks and cervical levels. These findings are expected to provide a basis for future studies of spinal degeneration and surgical efficacy.
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Conflict of interest
VC received a CNS Spine Fellowship grant, which partially supported this work. The sponsor had no involvement in study design, collection, analysis and interpretation of data, writing of the report, or decision to submit the article for publication. VC is a consultant for DePuy/Synthes Spine and Globus Medical. SWB owns shares in Sentio LLC, is a consultant for LDR, and a member of the Medical Board of Trustees of MTF. AB declares that he has no conflict of interest. TB declares that he has no conflict of interest. DO declares that he has no conflict of interest. CPM declares that he has no conflict of interest. MJB declares that he has no conflict of interest. YNY declares that he has no conflict of interest.
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Chang, V., Basheer, A., Baumer, T. et al. Dynamic measurements of cervical neural foramina during neck movements in asymptomatic young volunteers. Surg Radiol Anat 39, 1069–1078 (2017). https://doi.org/10.1007/s00276-017-1847-6
- Cervical spine
- Neural foramen
- Motion analysis
- Dynamic X-ray
- Neck rotation
- Neck extension