Imaging Parameter Analysis Of Posterior Percutaneous Spinal Endoscopy In The Treatment Of Cervical Spondylotic Radiculopathy

Object Systematic measurement and analysis of Imaging data of patients with cervical spondylotic radiculopathy were performed by PascView imaging system software,to explore the safety parameters of posterior percutaneous spinal endoscopy for the treatment of cervical spondylotic radiculopathy of decompression range around the V-point,which provided theoretical basis of anatomy and imageology for clinical development of such technologies.Method Thirty patients diagnosed as cervical spondylotic radiculopathy from the pain department of the Second Affiliated Hospital of Nanhua University from January 2018 to July 2018 were collected as subjects.All patients were aged between 20 and 75 years old.On the PascView imaging system software,the patient’s cervical CT three-dimensional reconstruction image data and cervical MRI image data were acquired,and the imaging data was measured at the PascView imaging system software.On the acquired corresponding images,sagittal planes parallelto the central axis of the human body are established with the centreline of the spinous process,and transverse planes parallel to the horizontal plane are established with C3/4,C4/5,C5/6 and C6/7 intervertebral spaces respectively.The following points are selected: the sagittal plane parallel to the spinous process midline is established at point V(the lower edge of the upper lamina,the upper edge of the lower lamina and the junction point of the medial facet of the articular process),the lateral edge of the dural sac and the lateral edge of the adjacent lower pedicle isthmus,and the transverse plane parallel to the intervertebral space plane is established at the lower edge of the adjacent upper pedicle isthmus and the upper edge of the adjacent lower pedicle isthmus.On MRI cross-sectional images of cervical spine,the distance from the lateral edge of dural sac to the midline of spinous process in C3/4 ~ C6/7segments was measured.The distance from the V point of each segment C3/4 to C6/7 to the spinous process midline and the lateral edge of the adjacent inferior pedicle isthmus was measured on the three-dimensional reconstruction cross-sectional image of cervical vertebra CT,and the distance from the V point to the lower edge of the adjacent superior pedicle isthmus and the upper edge of the adjacent inferior pedicle isthmus was measured on the sagittal image corresponding to the lateral edge of the pedicle isthmus.Statistical analysis of the data shows that the safe parameter range of bone grinding around the V point is obtained,andthen the bone grinding range of cervical spine CT three-dimensional reconstruction images reexamined in 4 patients after surgery is measured and analyzed for verification.Result For the C3/4~C6/7 segment,the distance between the V point and the lateral margin of the dural sac were 2.31 ± 0.15 mm,1.98 ± 0.20 mm,1.95 ± 0.16 mm,1.13 ± 0.15 mm,the V point begins to gradually decrease from top to bottom;the distance from the V point to the outside margin of pedicle isthmus were 1.54±0.20 mm,2.18±0.27 mm,2.99±0.18 mm,5.55±0.16mm;The distance from point V to the lower edge of the adjacent upper pedicle isthmus were 4.57±0.21 mm,4.76±0.26 mm,5.65 ± 0.22 mm,4.96 ± 0.29 mm;The distance from the V point to the upper edge of the adjacent lower pedicle isthmus were 3.82±0.30 mm,3.72±0.32 mm,3.14±0.27 mm,3.07±0.28 mm.Conclusion The imaging data of this study provides a range of imaging and anatomical safety reference values for the clinical implementation of posterior percutaneous spinal endoscopic for the treatment of cervical spondylotic radiculopathy around the V-point to decompression.