Lasers in Medical Science

, Volume 33, Issue 3, pp 627–635 | Cite as

Influences of different lower cervical bone graft heights on the size of the intervertebral foramen: multiple planar dynamic measurements with laser scanning

  • Rui Yang
  • Mengjun Ma
  • Lin Huang
  • Jichao Ye
  • Yong Tang
  • Peng Wang
  • Dezhen Yin
  • Keng Chen
  • Weiping Li
  • Huiyong ShenEmail author
Original Article


The aim of this study is to evaluate the influences of different bone graft heights on the size of the intervertebral foramen, which will help determine the optimal graft height in clinical practice. Six fresh adult cadavers were used, with the C5-C6 vertebral column segment defined as the functional spinal unit (FSU). After discectomy, the C5/6 intervertebral height was set as the baseline height (normal disc height). We initially used spiral computed tomography (CT) to scan and measure the middle area of the intervertebral foramen when at the baseline height. Data regarding the spatial relationship of C5-C6 were subsequently collected with a laser scanner. Grafting with four different sized grafts, namely, grafts of 100, 130, 160, and 190% of the baseline height, was implanted. Moreover, we scanned to display the FSU in the four different states using Geomagic8.0 studio software. Multiple planar dynamic measurements (MPDM) were adopted to measure the intervertebral foramen volume, middle area, and areas of internal and external opening. MPDM with a laser scanner precisely measured the middle area of the intervertebral foramen as spiral CT, and it is easy to simulate the different grafts implanted. With the increase of the bone graft height, the size of the intervertebral foramen began to decrease after it increased to a certain point, when grafts of 160% of the baseline height implanted. MPDM of the intervertebral foramens with laser scanning three-dimensional (3D) reconstitution are relatively objective and accurate. The recommended optimal graft height of cervical spondylosis is 160% of the mean height of adjacent normal intervertebral spaces.


Laser scanning 3D reconstruction Multiple planar dynamic measurements Cervical spondylosis Lower cervical spine Intervertebral foramen Bone graft height 


Funding information

This study was funded by the National Natural Science Foundation of China (grant number 81472102, U1301223) and the National Natural Science Foundation of Guangdong Province (grant number 2015A030313085). The funders had no role in the study design, experiment conduction and data analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The procedure was approved by the Institutional Human Investigation Committee of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Statement of informed consent

This study was performed on cadaver specimens; thus, “Informed Consent” was not applicable.


  1. 1.
    Wang LY, Chen DY, Guo YF, Xu JW, Wang XW (2004) Efffect of the anterior column height of cervical spondylotic myelopathy on the functional improvement rate by anterior decompression and interbody fusion. Chin J Clin Rehabil 8:201–203Google Scholar
  2. 2.
    Wu J, Gao B, Tan H, Chen J, Tang CY, Tsui CP (2010) A feasibility study on laser rapid forming of a complete titanium denture base plate. Lasers Med Sci 25:309–315CrossRefPubMedGoogle Scholar
  3. 3.
    Sotsuka Y, Nishimoto S, Tsumano T, Kawai K, Ishise H, Kakibuchi M, Shimokita R, Yamauchi T, Okihara S (2014) The dawn of computer-assisted robotic osteotomy with ytterbium-doped fiber laser. Lasers Med Sci 29:1125–1129CrossRefPubMedGoogle Scholar
  4. 4.
    Li Q, Li B, Chen J (2001) Research on laser range scanning and its application. Geo Spat Inf Sci 4:37–42Google Scholar
  5. 5.
    Kau CH, Cronin A, Durning P, Zhurov AI, Sandham A, Richmond S (2006) A new method for the 3D measurement of postoperative swelling following orthognathic surgery. Orthod Craniofac Res 9:31–37CrossRefPubMedGoogle Scholar
  6. 6.
    Yeganeh S, Lynch E, Jovanovski V, Zou L (1999) Quantification of root surface plaque using a new 3-D laser scanning method. J Clin Periodontol 26:692–697CrossRefPubMedGoogle Scholar
  7. 7.
    Kau CH, Zhurov A, Bibb R, Hunter L, Richmond S (2005) The investigation of the changing facial appearance of identical twins employing a three-dimensional laser imaging system. Orthod Craniofac Res 8:85–90CrossRefPubMedGoogle Scholar
  8. 8.
    Schmidburg I, Pagger H, Zsoldos RR, Mehnen J, Peham C, Licka TF (2012) Movement associated reduction of spatial capacity of the equine cervical vertebral canal. Vet J 192:525–528CrossRefPubMedGoogle Scholar
  9. 9.
    Araki D, Kuroda R, Matsumoto T, Nagamune K, Matsushita T, Kubo S, Oniki Y, Kurosaka M (2013) An analysis of surface profile for cylindrical osteochondral grafts of the knee quantitative evaluation using a three-dimensional laser scanner. Knee Surg Sports Traumatol Arthrosc 21:1794–1800CrossRefPubMedGoogle Scholar
  10. 10.
    Ebraheim NA, An HS, Xu R, Ahmad M, Yeasting RA (1996) The quantitative anatomy of the cervical nerve root groove and the intervertebral foramen. Spine (Phila Pa 1976) 21:1619–1623CrossRefGoogle Scholar
  11. 11.
    Hasegawa T, An HS, Haughton VM, Nowicki BH (1995) Lumbar foraminal stenosis: critical heights of the intervertebral discs and foramina. A cryomicrotome study in cadavera. J Bone Joint Surg Am 77:32–38CrossRefPubMedGoogle Scholar
  12. 12.
    Shinomiya K, Komori H, Matsuoka T, Mutoh N, Furuya K (1994) Neuroradiologic and electrophysiologic assessment of cervical spondylotic amyotrophy. Spine (Phila Pa 1976) 19:21–25CrossRefGoogle Scholar
  13. 13.
    Lestini WF, Wiesel SW (1989) The pathogenesis of cervical spondylosis. Clin Orthop Relat Res 239:69–93Google Scholar
  14. 14.
    Lee C, Woodring JH, Rogers LF, Kim KS (1986) The radiographic distinction of degenerative slippage (spondylolisthesis and retrolisthesis) from traumatic slippage of the cervical spine. Skelet Radiol 15:439–443CrossRefGoogle Scholar
  15. 15.
    Humphreys SC, Hodges SD, Patwardhan A, Eck JC, Covington LA, Sartori M (1998) The natural history of the cervical foramen in symptomatic and asymptomatic individuals aged 20-60 years as measured by magnetic resonance imaging. A descriptive approach. Spine (Phila Pa 1976) 23:2180–2184CrossRefGoogle Scholar
  16. 16.
    Robinson RA, Smith GW (2010) Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. SAS Journal 4:34–35CrossRefGoogle Scholar
  17. 17.
    White AA, Panjabi MM (1988) Biomechanical considerations in the surgical management of cervical spondylotic myelopathy. Spine (Phila Pa 1976) 13:856–860CrossRefGoogle Scholar
  18. 18.
    Panjabl MM (1998) Cervical spine models for biomechanical research. Spine 23:2684–2700CrossRefGoogle Scholar
  19. 19.
    Rothman RH, Simenone FA (1992) Anterior cervical fusion. In: Rothman R, Simeone F (eds) The spine, 3rd edn. WB Saunders, PhiladalphiaGoogle Scholar
  20. 20.
    Caspar W, Barbier DD, Klara PM (1989) Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery 25:491–502CrossRefPubMedGoogle Scholar
  21. 21.
    Clements DH, O'Leary PF (1990) Anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 15:1023–1025CrossRefGoogle Scholar
  22. 22.
    Tippets RH, Apfelbaum RI (1988) Anterior cervical fusion with the Caspar instrumentation system. Neurosurgery 22:1008–1013CrossRefPubMedGoogle Scholar
  23. 23.
    Brower RS, Herkowitz HN, Kurz L (1992) Effect of distraction on union rates of Smith-Robinson type anterior discectomy and fusion. 20th annual meeting of the Cervical Spine Research Society, Palm DesertGoogle Scholar
  24. 24.
    Olsewski JM, Garvey TA, Schendel MJ (1994) Biomechanical analysis of facet and graft loading in a Smith-Robinson type cervical spine model. Spine 19:2540–2544CrossRefPubMedGoogle Scholar
  25. 25.
    Cao SF, Jia LS, Kong QY, Zhao WD, Ouyang J, Zhong SZ (2003) An investigation of immediate biomechanical stability of lower cervical spine after subtotal corpectomy with distraction and grafting. J Clin Orthop 6:193–196Google Scholar
  26. 26.
    An HS, Evanich CJ, Nowicki BH, Haughton VM (1993) Ideal thickness of Smith-Robinson graft for anterior cervical fusion. A cadaveric study with computed tomographic correlation. Spine (Phila Pa 1976) 18:2043–2047CrossRefGoogle Scholar
  27. 27.
    Bayley JC, Yoo JU, Kruger DM, Schlegel J (1995) The role of distraction in improving the space available for the cord in cervical spondylosis. Spine (Phila Pa 1976) 20:771–775CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Rui Yang
    • 1
  • Mengjun Ma
    • 1
  • Lin Huang
    • 1
  • Jichao Ye
    • 1
  • Yong Tang
    • 1
  • Peng Wang
    • 1
  • Dezhen Yin
    • 2
  • Keng Chen
    • 1
  • Weiping Li
    • 1
  • Huiyong Shen
    • 1
    Email author
  1. 1.Department of Orthopedics, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina
  2. 2.Department of OrthopedicsWeihai Municipal HospitalWeihaiChina

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