Morphometric analysis of cervical intervertebral disc space to reduce neural complications during anterior approaches to the cervical spine

Abstract

BackgroundAlthough neurovascular complications rarely occur during surgical procedures, they have serious consequences. We reviewed the limits of safe surgery to decrease the possibility of neurovascular injuries. MethodsFour measurements were performed for each patient at the vertebral levels adjacent to the intervertebral discs at C3–C4, C4–C5, C5–C6, and C6–C7. These measurements were: 1)midline anteroposterior diameter of the intervertebral disc, 2)transverse diameter of the intervertebral disc, 3)right and left measurements of the line vertically drawn to the disc anterior from the most lateral point of the dura mater, and 4)measurement of the distance from measurement 3 to the right and left root. ResultsAverage anteroposterior and transverse vertebral diameters were determined to be 18.11 and 27.15 mm, respectively. Average of the results of the 3rd measurement was 5.51 mm on the right and 5.36 on the left. Average of the 4th measurement was 7.8 mm on the right 7.75 mm on the left. The shortest interval was at the C3-4 level and the longest interval was at the C6-7 level. ConclusionDetermining the safe surgery limits will help surgeons evaluating suitable implant sizes and decreasing the perioperative complications during decompression to cervical vertebrae and instrument procedures.