The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

3D-CT analysis on the safety of decompression by percutaneous posterior endoscopic cervical discectomy

Author : LIU Xin, SUN Zhao-zhong, CHENG Yan, et al.     
Working unit : Department of Spine Surgery, Binzhou Medical University Hospital, Binzhou 256600,China
Page : 247-251
Key words : cervical spondylopathy, endoscope, 3D-CT, safety

  Abstract:

Objective

To explore the accurate decompression range of percutaneous posterior endoscopic cervical discectomy with measurement of 3D-CT.

Methods

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) .

Results

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) .

Conclusion

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.


summary:
3D-CT analysis on the safety of decompression by percutaneous posterior endoscopic cervical discectomy   
LIU Xin, SUN Zhao-zhong, CHENG Yan, et al.
Orthop J Chin,2018,26(3):   247-251