Radiological determination of safe and adequate corpectomy limits in the cervical region

Radiological determination of safe and adequate corpectomy limits in the cervical region

Aim: This manuscript aims to display the relationship between the vertebral artery and its surrounding structures to maintain safeand effective corpectomy during anterior C4, C5, and C6 decompressive surgery.Material and Methods: Fifty patients who applied to the emergency department and received a cervical computed tomography(CT) scan were included, and their C4, C5, and C6 vertebrae margins were measured. The following distances were measured: thedistance between the medial wall of the vertebral foramen and lateral border of the anterior arch of the vertebral corpus, the distancebetween the junction of the corpus-the pedicle and inferior border of the vertebral foramen, the distance between the medial borderof the vertebral foramen and longus colli muscles, the distance between each vertebral foramen, and the bipedicular distance.Results: Fifty patients (22 females and 28 males) were assessed in this study. The female and male populations had mean ages of52.4 and 53.9 years, respectively. All measurements were higher in the lower vertebrae than those in the upper vertebrae. Also allthese measurements were found higher in males than females. The following results were reported: a value: C4, 4.1/4.3 (F/M); C5,4.6/4.9; and C6, 5/5.2 mm; b value: C4, 4.5/4.7; C5, 4.8/5.1; and C6, 5.1/5.5 mm; c value: C4, 8.6/9; C5, 9/9.6; and C6, 9.3/10.1 mm; dvalue: C4, 23.1/24; C5, 23.9/25.2; and C6, 24.5/25.5 mm; e value: C4, 19.3/20.4; C5, 20/21; and C6, 20.5/21.7 mm.Conclusion: The Distances between the vertebral artery and the surrounding structures and muscles will provide the surgeon a saferworking during anterior corpectomy surgery. These parameters should be taken into consideration during anterior corpectomy toobtain more secure and effective decompression.

___

  • 1. Smith GW, Robinson RA. The treatment of certain cervicalspine disorders by anterior removal of the intervertebral disc and interbody fusion. J. Bone Joint Surg Am 1958;40:607- 24.
  • 2. Cloward RB. The anterior approach for removal of ruptured cervical disks. J. Neurosurg 1958;15:602-17.
  • 3. Steinmetz MP, Stewart TJ, Kager CD, et al. Cervical deformity correction. Neurosurgery 2007;60:90-7.
  • 4. Tan LA, Riew KD, Traynelis VC. Cervical spine deformity- Part 2: Management algorithm and anterior techniques. Neurosurgery 2017;81:561-7.
  • 5. Miller JA, Lubelski D, Alvin MD, et al. C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications. Spine J 2014;14:2854-60.
  • 6. Minhas SV, Chow I, Jenkins TJ, at el. Preoperative predictors of increased hospital costs in elective anterior cervical fusions: a single-institution analysis of 1,082 patients. Spine J 2015;15:841-8.
  • 7. Nandyala SV, Elboghdady IM, Marquez-Lara A,et al. Cost analysis of incidental durotomy in spine surgery. Spine (Phila Pa 1976) 2014;39:E1042-E51.
  • 8. Lunardini DJ, Eskander MS, Even JL, et al. Vertebral artery injuries in cervical spine surgery. Spine J 2014;14:1520-5.
  • 9. Rampersaud YR, Moro ER, Neary MA, et al. Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols. Spine (Phila Pa 1976) 2006;31:1503-10.
  • 10. Daentzer D, Deinsberger W, Boker DK. Vertebral artery complications in anterior approaches to the cervical spine: report of two cases and review of literature. Surg Neurol 2003;59:300-9.
  • 11. Burke JP, Gerszten PC, Welch WC. Iatrogenic vertebral artery injury during anterior cervical spine surgery. Spine J 2005;5:508-14.
  • 12. Fassett DR, Dailey AT, Vaccaro AR. Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech 2008;21:252-8.
  • 13. Stemper BD, Yoganandan N, Pintar FA, et al. Anatomical gender differences in cervical vertebrae of size-matched volunteers, Spine 2008;33:E44-9.
  • 14. David E, Youssef M, Khalil S, et al. Demographical aspects in cervical vertebral bodies’ size and shape (c3-c7): a skeletal study. Spine J 2017;17:135-142.
  • 15. Herzo RG, Wiens JJ, Dillingham MF, et al. Normal cervical spine morphometry and cervical spinal stenosis in asymptomatic professional football players. Plain film radiography, multiplanar computed tomography, and magnetic resonance imaging, Spine 1991;16:S178-86.
  • 16. Güvençer M, Naderi S, Men S, et al. Morphometric evaluation of the uncinate process and its importance in surgical approaches to the cervical spine: a cadaveric study. Singapore Med J 2016;57:570-7.
  • 17. Peng CW, Chou BT, Bendo JA, et al. Vertebral artery injury in cervical spine surgery: anatomical considerations, management, and preventive measures. Spine J 2009;9:70- 6.
  • 18. Sanchis-Gimeno JA, Blanco-Perez E, Llido S, et al. Can the transverse foramen/vertebral artery ratio of double transverse foramen subjects be a risk for vertebrobasilar transient ischemic attacks? J Anat 2018;7.
  • 19. Nourbakhsh A, Yang J, Mcmahan H, et al. Transverse process anatomy as a guide to vertebral artery exposure during anterior cervical spine approach: a cadaveric study. Clin Anat 2017;30:492-7.
  • 20. Smith MD, Emery SE, Dudley A, et al. Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 1993;75:410-5.
  • 21. Eskander MS, Drew JM, Aubin ME, at al. Vertebral artery anatomy: a review of two hundred fifty magnetic resonance imaging scans. Spine (Phila Pa 1976) 2010;35:2035-20-40.
  • 22. Sarkar S, Nair BR, Rajshekhar V. Complications following central corpectomy in 468 consecutive patients with degenerative cervical spine disease. Neurosurg Focus 2016;40:E10.
  • 23. Nooti Venkata Srinivasa Rao, Vedantam Rajshekhar, Distal-type cervical spondylotic amyotrophy: incidence and outcome after central corpectomy J Neurosurg Spine 2009;10:374-9.
  • 24. Odate S, Shikata J, Yamamura S, et al. Extremely wide and asymmetric anterior decompression causes postoperative C5 palsy: an analysis of 32 patients with postoperative C5 palsy after anterior cervical decompression and fusion. Spine (Phila Pa 1976) 2013;38:2184-9.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Do hemoglobin levels affect the progression of chronic kidney disease in patients with stage 3-4 chronic kidney disease?

Yasin ŞAHİNTÜRK, Metin SARIKAYA, Aygül ÖZDEMİR, Ali Rıza ÇALIŞKAN

HER-2/neu alterations in non-small cell lung cancer: A comprehensive evaluation by fluorescence in situ hybridization and immunohistochemistry

Zekiye AYDOĞDU, Sait TÜMER, Aydanur KARGI, Sebnem YİLDİRİMCAN KADİCESME, Cigdem Eresen YAZİCİOGLU, Oğuz ALTUNGÖZ

Evaluation of therapeutic and prophylactic platelet transfusion practices in a neonatal intensive care unit

Cüneyt TAYMAN, Davut BOZKAYA, Sabriye KORKUT

The frequency of laryngeal involvement in lipoid proteinosis patients

Isa AN, Yavuz YESİLOVA, Ismail IYNEN, Osman TANRIKULU, Ahmet YÜKKALDIRAN, Mahmut DEMİR, Mustafa AKSOY

Cancer is seen more in older female patients with psoriasis : A cross-sectional study in 1551 patients

Habibullah AKTAŞ, Cansu SERİFOGLU

YouTube as an information source for intra-articuler knee injection

Emel ATAR, Çiğdem ARİFOĞLU KARAMAN, Okan KÜÇÜKAKKAŞ, Arife Hilal BERBEROGLU, Merve BERGİN KORKMAZ

Developmental assessment of children with Down syndrome

Meltem KIVILCIM, Serpil DİNCER, Sinem Kortay CANALOGLU, Derya GÜMÜŞ DOĞAN

Probable “Escitalopram induced” angioedema in a patient with hereditary angioedema

Gökhan AYTEKİN, Ahmet Zafer CALİSKANER, Sevket ARSLAN, Eray YILDIZ, Fatih COLKESEN

Can platelet Iymphocyte ratio and neutrophil to lymphocyte ratio be used as prognostic predictors for hepatocellular carcinoma?

Gökhan MORAY, Ebru Hatice AYVAZOGLU SOY, Hüseyin Onur AYDIN

Slient death

Bilgehan DEMİRKALE