Abstract:Objective To observe the morphology of cervical intervertebral foramen and the related diameters in 3-dimensional space in patients with cervical intervertebral radiculopathy with C5/C6 intervertebral foramen stenosis, and to discuss the clinical significance. Methods A total of 492 patients with cervical spondylotic radiculopathy with C5/C6 intervertebral foramen stenosis, who underwent surgery in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Sep. 2014 to Jul. 2019, were randomly enrolled as case group and examined by anterior and lateral X-ray of the cervical vertebra, cervical computed tomography (CT), and cervical magnetic resonance imaging. In addition, 191 healthy adults who came to the hospital for health examination were enrolled as normal adult group. The morphology of C5/C6 intervertebral foramen was observed using CT 3-dimensional reconstruction images and X-ray films; and the upper anteroposterior diameter, lower anteroposterior diameter, longitudinal diameter, cross-sectional area, and disc height were measured under optimal projection angle. The differences between the case group and the normal adult group, between the observation side (stenosis or severe stenosis) intervertebral foramen and the contralateral intervertebral foramen of the case group, and between the male and female patients of the case group were analyzed. Results The morphology of C5/C6 intervertebral foramen in the case group was mainly spindle and irregular due to osteophyte hyperplasia. The mean transverse diameter, longitudinal diameter, cross-sectional area, and mean disc height of observation side intervertebral foramen in the case group were (5.81±1.40) mm, (10.45±1.70) mm, (50.02±15.46) mm2, and (4.99±0.89) mm, respectively, which were significantly lower than those in the normal adult group (［7.60±1.37］ mm, ［11.66±1.95］ mm, ［72.80±22.48］ mm2, and ［5.78±0.95］ mm, respectively) (all P＜0.05). There were no significant differences in the above-mentioned diameters between the observation side and contralateral intervertebral foramen of the case group or between the male and female patients (all P＞0.05). Conclusion The morphology changes of cervical intervertebral foramen lead to decreases in the mean transverse diameter and cross-sectional area in patients with cervical spondylotic intervertebral radiculopathy with C5/C6 intervertebral foramen stenosis. During intraoperative decompression, more attention should be paid to the effective enlargement of the transverse diameter of the intervertebral foramen, so as to improve the effect of the operation.
