Comparison of morphology between patients with and without developmental spinal canal stenosis to inform the feasibility of C1 lateral mass screw insertion in the atlas.
J Orthop Sci
; 22(2): 207-212, 2017 Mar.
Article
em En
| MEDLINE
| ID: mdl-28017708
ABSTRACT
BACKGROUND:
C1 lateral mass screws are increasingly being used as an effective anchoring system. Insufficient posterior arch height increases difficulty of inserting the screws using the Tan method. The general aim of our retrospective cross-sectional study was to clarify the atlas morphology of patients with developmental spinal canal stenosis to evaluate the usefulness of the Tan method.METHODS:
A computed tomography myelogram was performed in 85 Japanese patients presenting with spinal disorders. The following morphological measures at the level of the atlas were obtained anterior-posterior length (APL), medial-lateral width (MLW), lateral mass transverse diameter (LMTD), dural sac area (DSA), spinal cord area (SCA), lateral mass height (LMH), lateral mass width (LMW), lateral mass length (LML), posterior arch length (PAL), posterior lamina height (PLH), and posterior vertebral groove height (PVGH). Patients were classified into two groups patients with developmental spinal canal stenosis (DCS), identified by a longitudinal diameter of the spinal canal <12 mm and patients without developmental spinal canal stenosis (NDCS), identified by a longitudinal diameter of the spinal canal ≥12 mm. Measures obtained on the computed tomography images were compared between the two groups.RESULTS:
Among the 85 patients in our study group, developmental spinal stenosis was identified in 47 patients. The APL, DSA, PAL and PVGH measurements were significantly smaller among the 47 patients in the DCS group, compared to the 38 patients in the NDCS group (p < 0.01). The mean height of the PVGH was <4.0 mm in 63.5% of the total study group.CONCLUSIONS:
The normally inserted C1 lateral mass screws have a diameter of 3.5-4.0 mm, and hence, the Tan method require a posterior arch height that exceeds this value. Our study provides evidence of a narrower posterior arch in Japanese individuals with developmental spinal canal stenosis. Therefore, the safe use of the Tan method to insert C1 lateral mass screws may be limited in Japanese individuals with developmental spinal canal stenosis.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Canal Medular
/
Fusão Vertebral
/
Estenose Espinal
/
Imageamento Tridimensional
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Orthop Sci
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Japão