Basic And Clinically Applied Anatomy Of The Cervical Uncinate Joint

Objective:Use imaging,Micro-CT and finite element analysis to observe the morphology and internal microstructure of the uncinate joints of the cervical spine to discover the developmental laws and changes of the uncinate joints and the microstructure of the uncinate process with age and vertebral sequence growth.Features.Through the study of the uncinate process bone trabecular structure and the changes in the stress and displacement of the cervical uncinate joints after the uncinate process is removed,it provides a theoretical basis for clinical diagnosis and treatment of cervical spondylosis.Methods:1.Use CT to scan the cervical segment of the spine and measure the relative structural parameters of the positional relationship between the uncinate process and the uncinate process and the vertebral artery through three-dimensional reconstruction;2.Use Micro-CT to perform a complete scan of the cervical spine specimen to observe the internal bones of the uncinate process The arrangement and morphological characteristics of the trabeculae;3.Using finite element analysis technology,three-dimensional modeling of the skull base,cervical vertebrae,intervertebral discs and ligaments,etc.,from the normal cervical spine to the removal of different areas of the uncinate process,flexion and extension,Left and right lateral flexion and left and right rotation to observe the stress and displacement changes of the hook joints under six working conditions.Results:1.The length,height,and width of the uncinate process gradually increase with the vertebral order,and with age,there are significant differences between the side and gender(P<0.05);bilateral uncinate process,uncinate forefoot The distance between the feet of the uncinate process and the foramen of the uncinate process and the foramen of the uncinate process gradually increase with the vertebral sequence,but the change is not obvious with age.The overall shape is wavy.There are only some significant differences between side and gender(P<0.05);the angle of the uncinate process is about 130°,which does not change significantly with the increase of vertebral sequence and age;the sagittal angle of the uncinate process is about 15°,which is wavy with the increase of vertebral sequence and age;the anteroposterior diameter and vertebral diameter of the neural tube The overall foramen area changed insignificantly with the increase of vertebral sequence and age.The area of intervertebral foramen was larger in men than in women.The anterior height and posterior height of the intervertebral space increased gradually with the increase of the vertebral sequence,but slowly decreased with the increase of age.2.The distance between the tip of the uncinate process and the vertebral artery showed a "V" shape as the vertebral sequence increased,and gradually increased with age;the maximum transverse inclination angle of the pedicle did not change much with the increase of vertebral sequence,and showed a slow increase with age Decrease;the minimum pedicle tilt angle generally shows a decreasing trend with the increase of vertebral sequence,and it is not significant with the increase of age;the range of pedicle tilt angle generally gradually increases with the increase of vertebral sequence,and the range of pedicle tilt angle generally increases with age.Was wavy;the overall pedicle width showed an increasing trend with the increase of vertebral sequence,and slowly increased with age.3.The arrangement of the trabeculae of the uncinate process is consistent with that of the vertebral body.The coronal plane is mostly vertical walking shape,and the trabecula of the uncinate process continues directly in the vertebral body,Consistent with the arrangement in the vertebral body;the uncinate trabecular parameters TV,BV,BS,BS/BV,BV/TV,BS/TV,Tb.Th,Tb.N,Tb.Sp,Eu.N,Conn,DA,and SMI,except for individual ones,were not significantly different among the sides(P>0.05);the morphometric parameters of the cervical uncinate trabecula were compared between different vertebral sequences,only in TV,BV,and BV.The individual vertebral sequences of BS,BV/TV,BS/TV,Eu.N,Conn and SMI have significant differences(P<0.05),especially at C5,and the others have no significant differences(P>0.05).4.In the normal cervical spine,50%,100%of the left uncinate process and 100%of the bilateral uncinate process,the stress and displacement of the uncinate process in the four models of the related structure of the cervical spine,regardless of the movement conditions,follow The increase in vertebral order showed an increasing trend,with the largest being located at C5;the stress value of the normal group was only significantly different between left and right flexion(P<0.05),and the displacement value was different between flexion,extension,and left and right flexion.(P<0.05);The stress value of model group 1 only has significant difference in C5 flexion and extension(P<0.05),and there are differences between each vertebral side in left and right flexion(P<0.05),The stress values of model group 2 have significant differences in all working conditions(P<0.05),and the stress values of model group 3 have significant differences in anterior flexion,posterior extension,and left and right flexion conditions(P<0.05);and the displacement value has no difference in the last three model groups regardless of the working conditions(P>0.05);comparison between the vertebral sequence groups C5 and C3,C4,C₆,C₇ each group are different(P<0.05),there are differences between the normal group and the model groups 1,2 and 3 under certain working conditions(P<0.05).The stress and displacement values of the articular process in the 4 groups of models showed spikes with the increase of the vertebral sequence under any working conditions.The peak value of the normal group was located at C₆,while the model 1 to 3 groups were located at C5,and each vertebra in the 4 groups was only at There is a difference in left and right lateral flexion(P<0.05),and there is no difference in the rest(P<0.05).The comparative stress values between the vertebral sequence groups are under extension and left and right rotation.C5 and C₁-C4 and C₆-T1 are all in each group.Significant difference(P<0.05);comparison between the groups under the forward bending condition,there are significant differences between the normal group and the model 1-3 groups(P<0.05).The stress and displacement values of the anterior and posterior edges of the intervertebral discs in the four groups of models all showed an increasing trend with the increase of vertebral order,and their peaks were located at C5/6 under the six working conditions,and then showed a decreasing trend,showing a "spike-like" as a whole.There are significant differences in the marginal values under the conditions of forward flexion,extension and lateral flexion(P<0.05),the changes of the left and right edges are consistent with the front and rear edges,and there are significant differences under the conditions of forward flexion,lateral flexion and rotation(P<0.05);The stress values of the anterior and posterior edges and the left and right edges are basically not significantly different between the vertebral sequence(P>0.05),and the comparison between the groups only shows that there is a significant difference between the normal and model groups under certain working conditions(P<0.05),but the overall stress value does not change significantly.Conclusions:1.The length,height,and width of the uncinate process in the uncinate joints increase slowly with the vertebral sequence and age,which is in line with the law of gravity development of the spine;the distance between the bilateral uncinate process,the forefoot and the hindfoot of the uncinate process increases slowly with the vertebral sequence.Increasing trend,but the distance between the three is not very significant with increasing age;the distance between the uncinate process and the transverse foramen increases slowly with the increase of the vertebral sequence,but the change is not significant with the increase of age;the anterior and posterior diameter of the neural tube increases with the increase of the vertebral sequence and age The overall change is small;the uncinate process angle and the uncinate process sagittal angle are generally wavy with the increase in vertebral sequence and age.The uncinate process angle of about 130° is closely related to the stability of the cervical spine,while the uncinate process sagittal angle averages 15° It has the effect of restricting the excessive rotation of the cervical spine;the area of the intervertebral foramen is generally larger than that of women,and the overall change is not obvious with the increase of the vertebral sequence.The overall area of the intervertebral foramen changes little with age,but the width of the uncinate process is closely related to the area of the intervertebral foramen,Is one of the important factors causing the pathogenesis of cervical spondylotic radiculopathy;the anterior and posterior heights of the intervertebral space increase slowly with the increase of the vertebral sequence,and decrease with the increase of age.This is consistent with the growth and development of the spine.Excessive exercise and other factors cause degenerative changes in the cervical intervertebral discs,resulting in a decrease in the height of the intervertebral space,which causes the corresponding symptoms of cervical spondylosis.2.The distance between the uncinate process superior ridge and VAU showed a "V" shape with the increase of vertebral sequence,and showed a slow increase with age;the maximum of pedicle transverse angle inclination of the pedicle did not change much with the increase of vertebral sequence,but showed a slow decrease with age;the minimum pedicle transverse angle generally decreases with the increase of the vertebral sequence,but it is not significant with the increase of age;the range of pedicle transverse angle generally increases slowly with the increase of the vertebral sequence;the overall pedicle width increases with the increase of the vertebral sequence,Slowly increasing with age.3.Micro-CT can clearly observe the distribution characteristics,measurement and morphological parameters of the trabecular bone in the uncinate process of the cervical spine.The trabecular bone in the uncinate process has no significant difference between the sides and vertebral sequence,which is osteoporosis and cervical spondylosis.And the prevention,diagnosis and treatment of related diseases provide experimental theoretical basis.4.The stress and displacement of the uncinate process increase with the increase of the vertebral sequence.The maximum value is located at C5 far away from the gravity line.With the removal of different ranges of the uncinate process,the greater the range of resection,the more it affects the stability of the cervical spine;the stress of the articular process in the uncinate joint In the normal cervical spine,the stress concentration area is located at C₆,but the stress and displacement values are concentrated in C5 after the uncinate process is removed in different ranges;the stress and displacement values of the cervical intervertebral disc are concentrated in C5/6 under any circumstances.The force is not affected by the removal of the uncinate process.