Radiological analyses of the dimensions of the pedicle and dorsal part of the transverse process of subaxial vertebrae in the context of cervical spine surgery

Abstract

Background: Knowledge of the anatomical dimensions of distinct areas of the vertebral bodies and vertebral arches of the subaxial cervical spine are indispensable in the planning of osteosynthesis. The minute dimensions and complex anatomical orientation of the posterior vertebral arch structures in the subaxial spine render the insertion of screws - where needed - a challenging procedure. The pedicle option carries the risk of serious complications while the alternative of lateral mass only permits the insertion of short screws.

Objective: The transverse process of the subaxial vertebrae offers unique possibilities on all counts and seems quite comparable in its dimensions with the pedicle. To our knowledge it has not been used previously for the insertion of screws in the subaxial spine.

Methods: Therefore, the scans of 66 cervical spines were analysed for distinct lines of both structures.

Results: The widths and lengths of the dorsal part of the transverse processes and of the pedicles are similar between both sides. Clear differences between females and males could be observed. The widths of both structures were closer to each other in C3 than in C4 to C7, while the lengths derived the most in C7.

Conclusion: The dorsal part of the transverse process might be suitable for the insertion of screws to stabilize the vertebral arch of the subaxial cervical spine. Gender adaptation might be required.

Keywords: Cervical spine; Pedicle; Spine surgery; Transverse process; Tuberculum posterius.