USE OF CT FOR ANALYSIS OF THE VERTEBRAL FORAMEN IN THE HOSPITAL OF QUERÉTARO

Jesús Cisneros Lámbarri,José Grimaldo Tellez,José Tovar López,Haro Sandoval

doi:10.1590/s1808-185120171602172271

Jesús Cisneros Lámbarri, José Grimaldo Tellez + Show 2 more

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https://doi.org/10.1590/s1808-185120171602172271

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Abstract

ABSTRACT Objective: To determine the morphology of the vertebral foramen and its distance to the midline. Methods: Twenty cervical CT scans from the radiographic record of 12 men and 8 women, 18 to 74 years old, of C1 to C6 segments were evaluated, measuring the foramen diameter and its distance to the midline. We look for anomalies of vertebral foramen morphology, using Philips Ingenuity CT equipment with Philips IntelliSpace Portal software. Results: The mean age was 47 years; the segment with the most anomalies was C1, with 10% (increase in foramen diameter), followed by C2 and C6, with 5% (vertebral foramen hypotrophy); the mean diameter of the C1 to C6 segment was 6.081 mm, and the median distance from the midline to the vertebral foramen of C2 to C6 was 13.215 mm. The largest diameter of the vertebral foramen was C2, with a mean of 6.67 mm and the smallest was C4, with a mean of 5.75 mm; the greatest distance from the midline to the vertebral foramen was C1, with a mean of 22.59 mm and the shortest was C4, with a mean of 12.13 mm. Conclusions: The mean diameter of the vertebral foramen and its distance to the midline was determined, setting a safety region for procedures. In our city, there is no study that determines the means of the vertebral foramina diameters, the distance from the midline and its anomalies. It is necessary to rely on CT scans and to make a preoperative plan to avoid complications associated with morphological alterations.

Highlights

At the Hospital General de Querétaro, anterior cervical approach procedures are performed and, it is rare in this type of procedure, the consequences can be catastrophic, since they are associated with complications such as fistulas, pseudo-aneurisms, hemorrhages, thrombosis, cerebral ischemia, embolism, infection, and death.[1]
We looked for anomalies in the morphology of the vertebral foramen (VF). (Figure 1)
There are no studies to determine which is the morphological change most common in the vertebral foramen, in our study it is a decrease in the diameter of the foramen, which could affect the diameter of the vertebral artery, so that a lesion of the foramen and of the contralateral side of said anomaly could have catastrophic consequences, as previously mentioned

Summary

INTRODUCTION

At the Hospital General de Querétaro, anterior cervical approach procedures are performed and, it is rare in this type of procedure, the consequences can be catastrophic, since they are associated with complications such as fistulas, pseudo-aneurisms, hemorrhages, thrombosis, cerebral ischemia, embolism, infection, and death.[1]. The rates reported are variable and depend on the instrumentation technique used. They range from 4.1% to 8.2% for transarticular screws (C1-C2), and there are no lesions reported for subaxial lateral mass screws.[6]. Previous studies include patients with degenerative symptoms of the cervical spine or are focused on the Asian population. We believe that such data will provide the surgery with an improved understanding of pedicle anatomy and improve decision-making. C1 had the greatest mean distance from the midline to the vertebral foramen at 22.59 mm and C4 had the smallest mean distance at 12.13 mm. C1 had the greatest mean distance from the midline to the vertebral foramen at 22.59 mm and C4 had the smallest mean distance at 12.13 mm. (Table 1)

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CONCLUSION