363 Anatomic Study of Cervical Neural Foraminal Dimensions, Interpedicular Distance, and Disc Space Height From C2-T1 Using Computed Tomography of 1,000 Patients

Abstract

INTRODUCTION: The normative relationships among cervical neuroforaminal dimensions (NFD), interpedicular distance (IPD), and disc space height (DSH) remain unknown. METHODS: We reviewed CT imaging of 1,000 patients between 18 and 35 years of age without spinal pathology to measure cervical NFD, defined as follows: foraminal height, sagittal anterior-to-posterior width, and area. Anterior, middle, and posterior DSH, and IPD were also measured. Interobserver reliability was assessed via the intraclass correlation coefficient (ICC) two-way mixed model on absolute agreement. RESULTS: Bilateral NFD followed bimodal distribution patterns moving caudally from C2-T1, whereas DSH measurements exhibited multimodal distribution patterns and IPD demonstrated a unimodal distribution clustered at the lower cervical spine. Significant differences were observed in NFD, DSH, and IPD measurements with respect to patient sex and race taking into consideration patient demographic and anthropometric characteristics. The African American cohort demonstrated the smallest NFD, DSH, and IPD measurements, followed by the Hispanic cohort, followed by the Caucasian cohort. Weak-to-moderate correlations were observed among NFD, DSH, and IPD measurements across all levels. CONCLUSIONS: This study describes 70,800 DSH, NFD, and IPD measurements from C2-T1 using CT imaging of young patients without spinal pathology. Findings from this study may provide normative guidelines necessary to establish the foundation for diagnosis of cervical neuroforaminal stenosis. Surprisingly, this study found no strong, or even moderate, correlations between normative NFD, DSH, and IPD measurements across all levels from C2-T1. Patient sex, ethnicity, and height are associated with NFD, DSH, and IPD, though patient weight is not.