Radiological determination of safe and adequate corpectomy limits in the cervical region
Koc University Hospital Department of Neurosurgery, Istanbul, Turkey
Aim: This manuscript aims to display the relationship between the vertebral artery and its surrounding structures to maintain safe and effective corpectomy during anterior C4, C5, and C6 decompressive surgery.
Material and Methods: Fifty patients who applied to the emergency department and received a cervical computed tomography (CT) scan were included, and their C4, C5, and C6 vertebrae margins were measured. The following distances were measured: the distance between the medial wall of the vertebral foramen and lateral border of the anterior arch of the vertebral corpus, the distance between the junction of the corpus-the pedicle and inferior border of the vertebral foramen, the distance between the medial border of the vertebral foramen and longus colli muscles, the distance between each vertebral foramen, and the bipedicular distance.
Results: Fifty patients (22 females and 28 males) were assessed in this study. The female and male populations had mean ages of 52.4 and 53.9 years, respectively. All measurements were higher in the lower vertebrae than those in the upper vertebrae. Also all these measurements were found higher in males than females. The following results were reported: a value: C4, 4.1/4.3 (F/M); C5, 4.6/4.9; and C6, 5/5.2 mm; b value: C4, 4.5/4.7; C5, 4.8/5.1; and C6, 5.1/5.5 mm; c value: C4, 8.6/9; C5, 9/9.6; and C6, 9.3/10.1 mm; d value: C4, 23.1/24; C5, 23.9/25.2; and C6, 24.5/25.5 mm; e value: C4, 19.3/20.4; C5, 20/21; and C6, 20.5/21.7 mm.
Conclusion: The Distances between the vertebral artery and the surrounding structures and muscles will provide the surgeon a safer working during anterior corpectomy surgery. These parameters should be taken into consideration during anterior corpectomy to obtain more secure and effective decompression.