To explore the accurate decompression range of percutaneous posterior endoscopic cervical discectomy with measurement of 3D-CT.
Eight patients with cervical spondylopathy were selected for a check of
head and neck CT myelography (CTM) . Reconstruction of cervical spine
3D images was obtained with Mimics16.0 software. The various measurement
points were defined, including the point O, the intersection of the
lower-medial margin of the lateral mass with the outer lower margin of
the lamina; the point V, the intersection of the adjacent upper and
lower lamina; as well as dural lateral margin, medial margin of pedicle
isthmus M (in) exterior margin M (outside) , and central line of spinous
processes. Various distance and angle were measured, such as width of
the lateral mass (a) , horizontal distance of V and lateral border of
epidural(b) , O and M (in) (c) , O and M (outside) (d) ,O and V(e) , O
and lateral border of epidural(f) , central line of spinous and lateral
border of epidural (g) , the thickness superior and inferior articular
process overlap on cross section of O(h) .
There no significant difference was found in the f (4.03±1.67
mm~4.72±1.98 mm) and the h (6.06±2.07 mm~7.20±1.93 mm) between the
segment from C3-C4~C7-T1 (P＞0.05) . However, the significant difference
was found in the b (-0.17±1.74 mm~2.42±1.41 mm) among the segments from
C3-C4~C5-C6 to C7-T1 (P＜0.001) , the d (-0.75±1.27 mm ~2.85±1.69mm) from
C3-C4~C5-C6 to C7-T1 (P＜0.001) , the i (6.79±1.04 mm~9.57±1.27 mm) from
C3-C4~C5-C6 to C7-T1 (P＜0.001) ,the j (0.19±2.04 mm~2.36±1.39 mm) from
C3-C4~C6-C7 to C7-T1 (P＜0.01) .
The mark O divided surgical operation area into the central vertebral canal, the axillary, the shoulder and the intervertebral foramen region, The range of decompression range is constant, different regions have certain decompression point, the safe range and important structure. There is no need to damage the facet joints in the underarm and upper shoulder region, and is little effect on the facet joints to exposure of the intervertebral foramen area.