Asian Spine J.  2018 Feb;12(1):18-28. 10.4184/asj.2018.12.1.18.

Computed Tomography- and Radiography-Based Morphometric Analysis of the Lateral Mass of the Subaxial Cervical Spine in the Indian Population

Affiliations
  • 1Department of Orthopaedics, King Edward Memorial Hospital, Seth Gordhandas Sunderdas Medical College, Parel, Mumbai, India. nirmalpatil2008@gmail.com

Abstract

STUDY DESIGN: This was a double-blinded cross-sectional study, which obtained no financial support for the research. PURPOSE: To obtain a detailed morphometry of the lateral mass of the subaxial cervical spine. OVERVIEW OF LITERATURE: The literature offers little data on the dimensions of the lateral mass of the subaxial cervical spine.
METHODS
We assessed axial, sagittal, and coronal computed tomography (CT) cuts and anteroposterior and lateral X-rays of the lateral mass of the subaxial cervical spine of 104 patients (2,080 lateral masses) who presented to a tertiary care public hospital (King Edward Memorial Hospital, Mumbai) in a metropolitan city in India.
RESULTS
For a majority of the parameters, males and females significantly differed at all levels (p < 0.05). Females consistently required higher (p < 0.05) minimum lateral angulation and lateral angulation. While the minimum lateral angulation followed the order of C5 < C4 < C6 < C3, the lateral angulation followed the order of C3 < C5 < C4 < C6. The lateral mass becomes longer and narrower from C3 to C7. In axial cuts, the dimensions increased from C3 to C6. The sagittal cut thickness and diagonal length increased and the sagittal cut height decreased from C3 to C7. The sagittal cut height was consistently lower in the Indian population at all levels, especially at the C7 level, as compared with the Western population, thereby questioning the acceptance of a 3.5-mm lateral mass screw. A good correlation exists between X-ray- and CT-based assessments of the lateral mass.
CONCLUSIONS
Larger lateral angulation is required for Indian patients, especially females. The screw length can be effectively calculated by analyzing the lateral X-ray. A CT scan should be reserved for specific indications, and a caution must be exercised while inserting C7 lateral mass screws.

Keyword

Cervical; Nerve; Computed tomography scan

MeSH Terms

Cross-Sectional Studies
Female
Financial Support
Hospitals, Public
Humans
India
Male
Spine*
Tertiary Healthcare
Tomography, X-Ray Computed
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