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

Background: Although 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. Methods: Four 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 ante-roposterior 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. Results: Average 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. Conclusion: Determining the safe surgery limits will help surgeons evaluating suitable implant sizes and decreasing the perioperative complications during decompression to cervical vertebrae and instrument procedures. (C) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Automated summary

This study reviewed the safe surgery limits by measuring anatomical parameters at the vertebral levels adjacent to the intervertebral discs, providing guidance for surgeons to choose appropriate implant sizes and reduce perioperative complications during decompression and instrument procedures for cervical vertebrae.