The Inaccuracy of Surface Landmarks for the Anterior Approach to the Cervical Spine in Southern Chinese Patients
10.31616/asj.2018.12.6.1123
- Author:
Tin Sui KO
1
;
Michael SIU HEI TSE
;
Kam Kwong WONG
;
Wing Cheung WONG
Author Information
1. Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong. isaackoisaacko@gmail.com
- Publication Type:Original Article
- Keywords:
Surface landmarks;
Cervical spine;
Anterior approach;
Spine;
Anatomy
- MeSH:
Anatomic Landmarks;
Asian Continental Ancestry Group;
Cricoid Cartilage;
Female;
Fluoroscopy;
Humans;
Hyoid Bone;
Male;
Neck;
Observational Study;
Spine;
Thyroid Cartilage;
Thyroid Gland
- From:Asian Spine Journal
2018;12(6):1123-1126
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: Observational study. PURPOSE: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. OVERVIEW OF LITERATURE: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. METHODS: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. RESULTS: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. CONCLUSIONS: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.
