The change of intervertebral foramina in anterior cervical discectomy and fusion

English Keywords:Foramina  Cervical spondylosis  Anterior operation  Interbody fusion cage

English Abstract:

  【Abstract】 Objectives: To discuss the change of intervertebral foramina under anterior cervical discectomy and fusion. Methods: Twenty-nine patients with cervical spondylotic radiculopathy or cervical spondylotic myelopathy who were treated with single-level anterior cervical discectomy and fusion from October 2016 to April 2017 were retrospectively reviewed, including 18 males and 11 females with a mean age of 54.2±6.9 years(range, 40-66 years), 3 cases of C3/4 level, 9 cases of C4/5 level and 17 cases of C5/6 level. All the original data were transferred to 3D reconstruction with Aquarius iNtuition Viewer 4.4, the software tools were used to measure the intervertebral foramina related indexes including superior diagonal distance(DSI), inferior diagonal distance(DIS), height(H) and foraminal area(A). The measurements were analyzed statistically for the bilateral foramina of the operation level, cranial and caudal adjacent levels before and after operation. Results: There was no significant difference of the same bilateral foramina measurement in the same level between preoperation and postoperation(P>0.05). Preoperation DSI and DIS in the operation level, cranial and caudal adjacent levels were 5.55±0.81mm, 5.64±1.00mm, 5.48±0.95mm and 6.11±0.99mm, 5.91±1.02mm, 6.07±1.02mm; and postoperation those were 5.49±0.92mm, 5.73±0.94, 5.45±0.81mm and 6.04±1.06mm, 6.06±0.96mm, 6.01±1.01mm. There was no significant difference between preoperation and postoperation(P>0.05). The H and A in the operation level, cranial and caudal adjacent levels before operation were 8.70±1.08mm, 9.60±0.98mm, 9.20±1.00mm and 0.35±0.08cm2, 0.41±0.12cm2, 0.36±0.09cm2. The H and A in the operation level, cranial and caudal adjacent levels after operation were 9.35±1.02mm, 9.02±1.15mm, 8.62±1.08mm and 0.38±0.08cm2, 0.39±0.12cm2, 0.34±0.09cm2. The H and A in the operation level increased significantly(P<0.05), but the cranial and caudal adjacent levels decreased significantly(P<0.05). Conclusions: The anterior cervical discectomy and fusion can increase the H and A in the operation level and decrease the H and A in the cranial and caudal adjacent levels.