Language：Japanese   Publisher：Journal of Orthopaedic Science  

Background: Narrowness of the spinal canal is associated with the development of cervical myelopathy. While studies have addressed the sagittal diameter of the cervical spinal canal, few evaluated the correlation between the size of the spinal canal and the vertebral level. We addressed this issue. Methods: Our retrospective study included 102 patients with cranial or spinal disorders. We examined the correlation between the cervical spinal canal diameter (SCD) at C1 to C7 and the inner anteroposterior diameter (IAPD) of the atlas on CT images. Results: At C1, the SCD was largest, at C4 it was smallest. While there was a strong correlation between the IAPD and the SCD at C1 (r = 0.8), the correlation between the size of the atlas and the SCD at C4 to C7 was weak (r = 0.2–0.3). We divided our patients into a normal group (n = 34, SCD ≥ 12 mm at any levels) and a stenosis group (n = 68, SCD < 12 mm at all levels). The mean SCD at C2 to C7 was significantly larger in the normal group. There was no significant difference between the two groups with respect to the IAPD and the SCD at C1. Conclusions: The size of the subaxial spine does not necessarily affect the size of the atlas. The pathophysiology of spinal canal stenosis should be considered separately at the C1- and the subaxial level.

DOI： 10.1016/j.jos.2020.04.009

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PubMed

Language：English   Publisher：(公社)日本整形外科学会  

脊柱管サイズと椎体レベルとの関連を検討した。頭蓋疾患または脊椎疾患を有する102例(男性67例、女性35例、平均62歳)を対象に、CT上におけるC1～C7の頸部脊柱管径(SCD)とC1の内前後径(IAPD)との相関の有無を評価した。IAPDの平均値は30.1mm、SCDはC1が17.8mm、C2が14.3mm、C3が12.3mm、C4が11.8mm、C5が12.0mm、C6が12.4mm、C7が13.1mmで、C1が最も大きく、C4が最小であった。各パラメータと年齢、体重、身長との関連をみると、体重とIAPDとの間に中等度の相関、C1とC7のSCDとの間に弱い相関が認められ、患者年齢と各パラメータとの間に負の傾向がみられた。IAPDとSCDとの相関はC1において最も強く、C4～C7で弱くなっていた。また、IAPDとC2のSCDとの間に中等度～高度の相関、C2のSCDとC1、C3、C4、C5、C6、C7のSCDとの間に中等度～高度の相関が生じていた。このほか、SCDが12mm以上の正常群と12mm未満の狭窄群に分類すると、C2～C7におけるSCDは正常群の方が有意に高値を示し、IAPDとC1におけるSCDに有意差はみられなかった。脊柱管狭窄症の病態生理はC1レベルとそれ以下のレベルに分けて考える必要があると思われた。

Language：Japanese  

Language：Japanese  

Language：Japanese