Anatomical study of cervical intervertebral foramen in patients with cervical spondylotic radiculopathy

Purpose: To determine the underlying anatomical characteristics in patients with cervical spondylotic radiculopathy (CSR) by comparing those of surgically treated CSR patients with those of healthy subjects. Methods: Computed tomography (CT) scans of the cervical spine in 42 patients who underwent decompression surgery for CSR were investigated. As a control group, 42 age- and sex-matched healthy subjects were randomly selected from the 1272 subjects who underwent CT examinations of the entire spine as their routine medical check-up. Image measurements included C2-7 sagittal Cobb angle, spinal canal diameters, and angles of the nerve root groove at each level from C3 to C7, and the size of the intervertebral foramen and the size of osteophytes at each level from C3/4 to C7/T1. As for the frequency of osteophytes at the surgical level, we compared the operated and nonoperated intervertebral foramina among the CSR patients, and all other parameters were compared with the corresponding segments in the control group. Results: Forty-eight intervertebral segments were surgically treated in the CSR group. There was a higher incidence of osteophytes in the operated foramen (70.8%) than in the nonoperated foramen (28.2%, p < 0.01) in the patients with CSR. The anteroposterior diameter (width) of the foramen was significantly smaller at all levels in the CSR patients, whereas the height of the foramen did not significantly differ between the two groups. Conclusion: It can be speculated that the width of the intervertebral foramen (developmental factor) and the formation of osteophytes (spondylotic factor) were related to the onset of the CSR. (C) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.