An anatomical study of the spinous process of the seventh cervical vertebrae based on the three‑dimensional computed tomography reconstruction

Abstract

Palpation of the seventh cervical vertebra (C7) is important for the diagnosis and treatment of neck and chest conditions. However, the spinous process of C7 (C7-SP) displays an anatomical deviation among individuals. The present study aimed to clarify anatomic characteristics of C7-SP by using a three-dimensional (3D) computed tomographic (CT) reconstruction technique. A total of 245 subjects meeting the selection criteria were examined. After CT scanning, the images were reconstructed in 3D. All subjects were grouped according to their deviation of C7-SP: Deviating to the right (DR group), deviating to the left (DL group) and no deviation (ND group). Three distances and three angles were recorded on C7-SP. The vertical distances between the borders of the left and right transverse processes and the tip of the SP, were termed DLTS and DRTS, respectively. The length of the SP was also determined. The angle of the SP deviation was referred to as ∠α, the angle between the SP axis and the line crossing the tips of the transverse processes was referred to as ∠β and the angle between the vertebral body axis and the SP axis was referred to as ∠γ. Among the three groups, differences in ∠α and ∠β were statistically significant (P<0.05). Furthermore, the DLTS was significantly different between the DL and ND groups (P<0.05). In addition, a significant difference in the DRTS was identified between the DR and ND groups (P<0.05). 3D CT reconstruction was reliable for studying anatomic characteristics of C7-SP. Based on this, patients may be preliminarily grouped according to the deviation of their C7-SP and the measurement of the C7-SP may guide clinical diagnoses and treatments.

Variation in the morphology of spinous processes in the cervical spine – An objective and parametric assessment based on CT study

“…These results contrast with our current findings, i.e. no significant sexual dimorphism was observed, and those of Zhang et al [13] on a Chinese population, in which no statistically significant differences were observed in age or male to female ratio. Although this difference may be due to variation between populations, it could also be influenced by the fact that a more detailed evaluation was made possible by the use of more subtle, objective and continuous descriptors of this feature.…”

“…The most commonly-used methods employed to evaluate cervical spine bifurcation are anthropological analysis of the human skeleton [2,3,5,8], anatomical dissection [11], and imaging studies of living subjects with X-ray or CT [7,12, 13]. Our present work, based on CT examination, developed objective anthropometric measurements for the quantitative assessment of the degree of the spinous process bifidity.…”

“…Shore and Duray distinguish three types of bifidity: full, partial or lack of bifurcation [5,6], while Cho et al propose a tripartite classification based on anatomical and CT study: lack of bifurcation, partial bifurcation or full bifurcation [7]. Our proposed classification is more accurate and less subjective because its criteria are based on quantitative morphometric measurements suggested inter alia by Zhang et al [13], dealing with morphometric measurements of the CVII spinous processes, which also suggests a proper methodology for performing measurements based on 3D CT scans.…”

Reference intervals of C2-C7 lateral spinous process deviation in Chinese adults

“…We also noticed that our results of LSPD angle were slightly different from other studies, possibly due to the differences between measuring methods [4,9,[14][15]. Nevertheless, our results are consistent with the conclusion of other studies that LSPD is common in the asymptomatic population [4-5, 7, 14].…”

“…performed an LSPD measurement using the angle between the line connecting two transverse processes tips and the midsagittal line through SP [4]. Zhang et al measured the LSPD with the angle between the long axis of SP and the median line of the vertebra in the superior aspect [15]. The six methods mentioned above were common existing methods of LSPD measurement.…”