Morphometric Analysis of the Cervical Canal Using Computed Tomography Scan Among Patients With Neck Pain in North India

Abstract

Introduction Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. To avoid long-term disability caused by irreversible spinal cord damage, quick diagnosis and treatment are required. To our knowledge, until recently, there has been no report or study evaluating the cervical canal stenosis and associated facet joint arthrosis as the major cause of neck pain, so the current study used computed tomography (CT) scans to determine the prevalence of cervical canal stenosis and facet joint osteoarthrosis in patients who presented with neck pain, including its relationship with age, sex, and cervical spinal levels (C3-C7). Methods The current clinical descriptive cross-sectional study was conducted in the Department of Anatomy and Radiodiagnosis at Santosh Medical College, Ghaziabad, for a period of 24 months among newly diagnosed outpatient department (OPD) cases of neck pain (18 years or older) with suspected cervical canal stenosis and facet joint arthrosis. Clinical history, patient-specific clinical examination, and relevant information were obtained in a structured data collection schedule through interviews during OPD hours. All of the participants underwent a CT scan of the cervical region. The independent factors (age, gender, height, and weight) were used in a multiple linear regression analysis of neck pain grading, Torg ratio (TR), and right and left facet joint degeneration, which were expressed as R-squared (R 2 ) and adjusted R-squared (aR 2 ). Statistical tests were executed at a 5% level of significance; an association was considered significant if the p-value was <0.05. Results A total of 83 subjects were enrolled in this study with equal representation from both sexes, i.e., males (49.4%) and females (50.6%). The transverse vertebral canal (T-VC) diameter was narrowest at the level of C3 (25.00 ± 1.13) and gradually increased at the level of C6 (25.18 ± 1.14) in this study. The mean TR of cervical vertebrae C3-C4 dropped gradually from C3 (0.78 ± 0.05) to C7 (0.76 ± 0.05) in this study. Severe left and right facet joint degeneration were observed in 13.3% and 10.5% of study subjects, respectively. In almost every subject, neck pain was a neurological symptom, so multiple linear regression analysis of neck pain grading was carried out with the independent variables (age, gender, height, and weight) and it was found to be not significant (R 2 = 0.0617, aR 2 = 0.0136, p = 0.2842). Conclusion The articulations of the posterior arch of the vertebrae are known as facet joints. They are a vital component of the vertebral column's structural stability. The superior and inner articular facets of the vertebrae are joined by these joints, which are encased in a fibrous capsule.

Radiological and anatomical evaluation of the cervical spinal cord, spinal canal, and intervertebral disc morphometry in healthy adults

“…It distributes the load on the joint surfaces equally and acts as a cushion. IVDs, which are generally 2/5 of the vertebral height, consist of nucleus pulposus in the inner part and annulus fibrosus in the outer part [1][2][3][4]13,[22][23][24][25][26][27] . Early recognition and diagnosis of any pathology or deviation from normality involving the cervical intervertebral disc can help prevent and delay morphological deterioration that may pose a serious risk in the future 27 .…”

“…The cervical vertebrae's body is the lowest. Also, tumors, infections, trauma, and degenerative changes such as intervertebral disc herniation, and osteophytes can induce the cervical canal to narrow 13 . Morishita et al suggested that a cervical spinal canal diameter of less than 13mm might predispose to the development of pathological changes in the cervical intervertebral discs, and the presence of a congenitally narrow canal may be an important reason for the development of cervical spinal stenosis 14 .…”