1.Imaging anatomy study on utilizing uncinate process "inflection point" as a landmark for anterior cervical spine decompression surgery.
Jianfeng JIANG ; Jun MA ; Maoyu YANG ; Yaozheng HAN ; Lintao SU ; Changyu LEI ; Chenguang GE ; Hui KANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):332-340
OBJECTIVE:
To explore the anatomical parameters of the cervical uncinate process "inflection point" through cervical CT angiography (CTA) and MRI measurements, offering a reliable and safe anatomical landmark for anterior cervical decompression surgery.
METHODS:
A retrospective analysis was conducted on the cervical CTA and MRI imaging data of normal adults who met the selection criteria between January 2020 and January 2024. The CTA dataset included 326 cases, with 200 males and 126 females, aged 22-55 years (mean, 46.7 years). The MRI dataset included 300 cases, with 200 males and 100 females, aged 18-55 years (mean, 43.7 years). Based on the CTA data, three-dimensional models of C 3-C 7 were constructed, and the following measurements were obtained from the superior view: uncinate process "inflection point" to vertebral artery distance (UIVD), uncinate process tip to vertebral artery distance (UTVD), uncinate process "inflection point" to "inflection point" distance (UID), uncinate process long-axis to sagittal angle (ULSA), and uncinate process "inflection point" to transverse foramen-sagittal angle (UITSA). From the anterior view, the anterior uncinate process to sagittal angle (AUSA) was measured. From the posterior view, the posterior uncinate process to sagittal angle (PUSA) was measured. Based on the MRI data, uncinate process "inflection point" to dural sac distance (UIDD) and dural sac width (DSW) were measured. The trends in measurement parameters of C 3-C 7 were observed, and the differences in measurement parameters between genders and between the left and right sides of the same segment were compared, as well as the difference in UID and DSW within the same segment was compared.
RESULTS:
The measurement parameters from C 3 to C 7 in the CTA data showed a general increasing trend, with no significant difference between the left and right sides within the same segment ( P>0.05). The UIVD, UTVD, and UID were greater in males than in females, with significant differences observed in the UIVD and UTVD at C 3 and C 6 and UID at C 3, C 6, and C 7 ( P<0.05). The MRI measured DSW showed a general increasing trend from C 3 to C 7, and the DSW at C 6 was greater in females than in males, with a significant difference ( P<0.05). The UIDD showed a gradual decreasing trend, with the smallest value at C 6. There was no significant difference between males and females or between the left and right sides within the same segment ( P>0.05). The UID was greater than the DSW at C 3-C 7, and the differences were significant ( P<0.05).
CONCLUSION
The uncinate process "inflection point" is a constant anatomical structure located at the anteromedial aspect of the uncinate process tip and laterally to the dural sac. It maintains a certain safe distance from the vertebral artery. As a decompression landmark in anterior cervical spine surgery, it not only ensures surgical safety but also guarantees complete decompression.
Humans
;
Adult
;
Male
;
Female
;
Middle Aged
;
Retrospective Studies
;
Cervical Vertebrae/surgery*
;
Magnetic Resonance Imaging
;
Decompression, Surgical/methods*
;
Young Adult
;
Adolescent
;
Computed Tomography Angiography
;
Imaging, Three-Dimensional
;
Vertebral Artery/anatomy & histology*
;
Anatomic Landmarks/diagnostic imaging*
2.Quantitative Study on Morphological Parameters of Healthy Cervical Spinal Cord Based on SCT.
Wei JIN ; Hao LIU ; Ruiyao JIANG ; Guangqi LIU
Chinese Journal of Medical Instrumentation 2025;49(2):141-147
OBJECTIVE:
To utilize Spinal Cord Toolbox (SCT) to measure the morphological parameters of healthy cervical spinal cords and explore the impact of gender, age and vertebral levels on them.
METHODS:
A retrospective study was conducted, collecting cervical spinal cord magnetic resonance images of 184 healthy adults. Then, cross-sectional area (CSA), eccentricity, antero-posterior diameter (AP) and right-left diameter (RL) were each computed for every subject. Then, impacts of gender, age and vertebral level on CSA and eccentricity were explored. Moreover, linear correlation analysis was conducted among CSA, AP and RL.
RESULTS:
The CSA of the cervical spinal cord in males was significantly larger than that in females at C2~C7 segments (P<0.05) . For C2~C6 segments, there was no statistically significant difference in CSA between the young and middle-aged groups, but both were significantly larger than that of the elderly group. CSA of C4 was the largest whereas CSA of C7 was the smallest. Eccentricity values of C4 and C5 were significantly larger than those of other vertebral levels (P<0.05). Linear correlation was established between CSA, AP and RL at C2~C7 segments.
CONCLUSION
The results allow for minimizing inter-subject variability using normalization, and thereby highlighting the importance of morphological parameters as biomarkers in the research of cervical spinal lesions.
Humans
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Female
;
Male
;
Retrospective Studies
;
Middle Aged
;
Adult
;
Cervical Cord/anatomy & histology*
;
Magnetic Resonance Imaging
;
Young Adult
;
Aged
;
Cervical Vertebrae/anatomy & histology*
3.Adult Stature Estimation by Multiple Parameters of Body Torso Segment.
Rong Qi WU ; Tao WANG ; Qun SHI ; Bi XIAO ; Kai Jun MA ; Xin CHEN
Journal of Forensic Medicine 2017;33(3):236-238
OBJECTIVES:
To promote the further research on body stature estimation and the innovative applications based on the distances between the anatomical landmarks on body torso surface.
METHODS:
A specification for the collection of distances between the anatomical landmarks on body torso surface was established. The data of 933 cases of adult population in Yangtze River Delta region were collected. Multiple linear regression method was used to statistical analyse and establish the regression equation of stature estimation.
RESULTS:
A regression equation about 5 variables including gender (x₁), cervical vertebrae-coccyx line (x₂), sterna-pubis line (x₃), distance between acromion and iliospinale anterius (x₄) and shoulder breadth (x₅), and stature (y) was established, y=105.406+5.414 x₁+0.436 x₂+0.286 x₃+0.225 x₄+ 0.193 x₅.
CONCLUSIONS
The method is suitable for the rapid, simple and accurate estimation of stature for the forensic experts.
Adult
;
Body Height
;
Bone and Bones/anatomy & histology*
;
Cervical Vertebrae/anatomy & histology*
;
Female
;
Forensic Anthropology/methods*
;
Humans
;
Linear Models
;
Male
;
Regression Analysis
;
Torso/anatomy & histology*
4.Morphometric evaluation of the uncinate process and its importance in surgical approaches to the cervical spine: a cadaveric study.
Mustafa GÜVENÇER ; Sait NADERI ; Süleyman MEN ; Salih SAYHAN ; Süleyman TETIK
Singapore medical journal 2016;57(10):570-577
INTRODUCTIONThe uncinate process (UP) has an important role because of its relationship with the vertebral artery and spinal roots. Degenerative diseases cause osteophyte formation on the UP, leading to radiculopathy, myelopathy and vertebral vascular insufficiency, which may require surgical management. This study aimed to evaluate the morphometry of this region to shed light on the anatomy of the UP.
METHODSMorphometric data was obtained from 13 male formaldehyde-fixed cadavers. Direct measurements were obtained using a metal caliper. Computed tomography (CT) morphometry was performed with the cadavers in the supine position.
RESULTSDirect cadaveric measurements showed that the height of the UP increased from C3 (5.8 ± 1.0 mm) to C7 (6.6 ± 0.5 mm). On CT, the corresponding measurements were 5.9 ± 1.2 mm at C3 and 6.9 ± 0.6 mm at C7. The distance between the left and right apex of the UP from C3 to C7 also increased on both direct cadaveric and CT measurements (C3: 20.8 ± 1.0 mm and C7: 28.1 ± 2.4 mm vs. C3: 23.7 ± 3.4 mm and C7: 29.0 ± 3.0 mm, respectively). On CT, the distance between the UP and superior articular process at the C3 to C7 levels were 9.8 ± 1.7 mm, 7.9 ± 1.8 mm, 7.9 ± 1.6 mm, 7.8 ± 1.3 mm and 8.2 ± 1.7 mm, respectively.
CONCLUSIONDirect cadaveric and CT measurements of the UP are useful for preoperative evaluation of the cervical spine and may lead to better surgical outcomes.
Cadaver ; Cervical Vertebrae ; anatomy & histology ; physiology ; surgery ; Formaldehyde ; Humans ; Male ; Tomography, X-Ray Computed
5.Surgical Anatomy of the Longus Colli Muscle and Uncinate Process in the Cervical Spine.
Moon Soo PARK ; Seong Hwan MOON ; Tae Hwan KIM ; Jae Keun OH ; Hyung Joon KIM ; Kun Tae PARK ; K Daniel RIEW
Yonsei Medical Journal 2016;57(4):968-972
PURPOSE: There have been a few previous reports regarding the distances between the medial borders of the longus colli to expose the disc space. However, to our knowledge, there are no reports concerning longus colli dissection to expose the uncinate processes. This study was undertaken to assess the surgical relationship between the longus colli muscle and the uncinate process in the cervical spine. MATERIALS AND METHODS: This study included 120 Korean patients randomly selected from 333 who had cervical spine MRIs and CTs from January 2003 to October 2013. They consisted of 60 males and 60 females. Each group was subdivided into six groups by age from 20 to 70 years or more. We measured three parameters on MRIs from C3 to T1: left and right longus colli distance and inter-longus colli distance. We also measured three parameters on CT: left and right uncinate distance and inter-uncinate distance. RESULTS: The longus colli distances, uncinate distances, and inter-uncinate distances increased from C3 to T1. The inter-longus colli distances increased from C3 to C7. There was no difference in longus colli distances and uncinate distances between males and females. There was no difference in the six parameters for the different age groups. CONCLUSION: Although approximate guidelines, we recommend the longus colli be dissected approximately 5 mm at C3-5, 6 mm at C5-6, 7 mm at C6-7, and 8 mm at C7-T1 to expose the uncinate process to its lateral edge.
Adult
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Aged
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Cervical Vertebrae/*anatomy & histology/diagnostic imaging/*surgery
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Dissection
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Female
;
Humans
;
Male
;
Middle Aged
;
Neck Muscles/*anatomy & histology/diagnostic imaging/*surgery
;
Random Allocation
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Young Adult
6.Construction of a human cervical spine with bilateral vertebral artery fluid-solid coupling model.
Hui-hao WANG ; Zhi-bi SHEN ; Zhen DENG ; Kuan WANG ; Hong-sheng ZHAN ;
Journal of Zhejiang University. Medical sciences 2015;44(2):131-137
OBJECTIVETo construct a human cervical spine with bilateral vertebral artery fluid-solid coupling model.
METHODSHelical CT images under the principle of reverse engineering and meshed in finite element model(FEM) related software were used to establish a human cervical spine with bilateral vertebral artery fluid-solid coupling model. In the process of modeling of vertebral body, vertebral artery, ligament, intervertebral disc, cartilage and endplate large anatomic data and cadaver experiments results were referenced. From the morphology and function the simulation of model with real physiological status was tested.
RESULTSThe study showed that the stress concentration on the surface of vertebral body and the blood wall of the bilateral vertebral artery, and the result of the volume flow rate-time curve of bilateral vertebral artery of the model were consistent with the published literatures. This model was well consistent with the clinical phenomenon.
CONCLUSIONThe three-dimensional FEM of the human cervical spine established by the introduced method has been effectively verified. The modeling method would provide a new tool for research on the cervical spine biomechanics.
Biomechanical Phenomena ; Cadaver ; Cervical Vertebrae ; anatomy & histology ; Finite Element Analysis ; Humans ; Intervertebral Disc ; Models, Anatomic ; Tomography, Spiral Computed ; Vertebral Artery ; anatomy & histology
7.Measurement and clinical significance of cervical lordosis.
Yu-ting ZHANG ; Xiang WANG ; Hong-sheng ZHAN
China Journal of Orthopaedics and Traumatology 2014;27(12):1062-1064
Measurement of cervical lordosis is the basic method for evaluating cervical function, and important reference for determine treatment decision. However, how to choose appropriate measurement in accordance with different situation, as well as the relationship among these methods is not clear. An increasing number of studies suggested that different measurements could directly affect the judgment of cervical lordosis. Therefore, comparative study of cervical vertebrae plays an important role in clinical treatment for cervical spondylosis under different cervical curvature conditions.
Cervical Vertebrae
;
anatomy & histology
;
Humans
;
Lordosis
;
diagnosis
;
pathology
8.Computed tomographic evaluation of cervical vertebral canal and spinal cord morphometry in normal dogs.
Eunjeong SEO ; Jihye CHOI ; Mincheol CHOI ; Junghee YOON
Journal of Veterinary Science 2014;15(2):187-193
The height, width, and cross-sectional area of the vertebral canal and spinal cord along with the area ratio of spinal cord to vertebral canal in the cervical vertebra were evaluated in images obtained using computed tomography (CT). Measurements were taken at the cranial, middle, and caudal point of each cervical vertebra in eight clinically normal small breed dogs (two shih tzu, two miniature schnauzers, and four mixed breed), 10 beagles, and four German shepherds. CT myelography facilitated the delineation of the epidural space, subarachnoid space, and spinal cord except at the caudal portion of the 7th cervical vertebra. The spinal cord had a tendency to have a clear ventral border in the middle portion of the vertebral canal and lateral borders near both end plates. The height, width, and area of the vertebral canal and spinal cord in the cervical vertebra were increased as the size of dog increased. However, the ratio of the spinal cord area to vertebral canal area in the small dogs was higher than that of the larger dogs. Results of the present study could provide basic and quantitative information for CT evaluation of pathologic lesions in the cervical vertebra and spinal cord.
Animals
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Body Size
;
Cervical Vertebrae/*anatomy & histology/radiography
;
Dogs/*anatomy & histology/growth & development
;
Reference Values
;
Spinal Canal/*anatomy & histology/radiography
;
Spinal Cord/*anatomy & histology/radiography
;
Tomography, X-Ray Computed/*veterinary
9.Anatomical study on vertebral artety and its application in transpedicle screw fixation for upper cervical vetebrae.
Xing-Guo WU ; Jian HUANG ; Yu-Qing JIANG ; Wei-Kang GUO ; Jun WANG
China Journal of Orthopaedics and Traumatology 2014;27(9):772-774
OBJECTIVETo investigate the relationship of upper cervical pedicle and vertebral artery (VA) location in order to improve the safety of transpedicular screw insertion.
METHODSThe vertebral arteries on 12 sides of 6 adult pate cadaverous specimens were dissected. The distance between VA and VA groove at the atlas needling point of transpedicle screw, and the distance between VA and the inner edge of axis cervical foramen, and the VA external diameter in axis cervical foramen were measured respectively.
RESULTSThe distance between VA and VA groove was (1.96 ± 0.72) mm on the left and (1.99 ± 0.61)mm on the right at the atlas needling point of transpedicle screw, the distance between VA and the inner edge of axis cervical foramen was (2.23 ± 0.43) mm on the left and (2.30 ± 0.39) mm on the right, the VA external diameter in axis cervical foramen was (3.03 ± 0.48) mm on the left and (2.98 ± 0.75) mm on the right.
CONCLUSIONIt is unlikely to injury VA when the transpedicle screws of upper cervical vertebrae were implanted correctly besides high straddled VA, and the individualization must be performed in the process.
Adult ; Aged ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Pedicle Screws ; Vertebral Artery ; anatomy & histology
10.Finite element method analysis of anteflexion traction on various angles for the treatment of cervical spine.
Fang-Jun WANG ; Wei WEI ; Sheng-Hui LIAO ; Hong-Yu REN ; Bing-Hua FAN
China Journal of Orthopaedics and Traumatology 2014;27(7):592-596
OBJECTIVETo analyze the data of angle variation on traction based on a finite element model of complete cervical spine with straight physiological curvature, and try to give experimental reference and suggestion in treating cervical spondylosis.
METHODSA 43-year-old female patient with straight cervical spine was chosen and the CT scan data were collected. By using specially designed modeling system, a high quality finite element model of complete cervical spine with straight physiological curvature is generated,which included ligament and muscle according to anatomy. After the model was confirmed, traction was loaded with angle 0 degree, anterior 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, to observe the data of distance change on between adjacent intervertebral foramen, processus articularis, uncovertedral joint, intervertebral discs, and stress of anulus fibrosus and nucleus pulposus.
RESULTSWhen the angle was 0 degrees-15 degrees, the distance between intervertebral foramen, Luschka joint and processus articularis posterioris was enlarged, the tensile stress was adequate and compressive stress was small. It met the clinical requests.
CONCLUSION0 degree-15 degrees anterior position is suggested for the treatment of cervical spondylosis.
Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; anatomy & histology ; surgery ; Female ; Finite Element Analysis ; Humans ; Spondylosis ; surgery ; Traction ; methods

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