Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients
Background If the proportion of the spinal cord in the epidural space can be determined under C-arm fluoroscopy during cervical epidural block, a safe entry point for the epidural needle can be established. The aim of this study was the measurement of the cord to canal transverse diameter ratio of e...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2022-08-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-22006.pdf |
| _version_ | 1828525774954561536 |
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| author | So Young Lee In Young Kim Kyung Wook Jeong Taeha Ryu Sang Kyu Kwak Jin Yong Jung |
| author_facet | So Young Lee In Young Kim Kyung Wook Jeong Taeha Ryu Sang Kyu Kwak Jin Yong Jung |
| author_sort | So Young Lee |
| collection | DOAJ |
| description | Background If the proportion of the spinal cord in the epidural space can be determined under C-arm fluoroscopy during cervical epidural block, a safe entry point for the epidural needle can be established. The aim of this study was the measurement of the cord to canal transverse diameter ratio of each cervical spines. Methods We retrospectively evaluated the imaging data of 100 patients who underwent both cervical computed tomography (CT) and cervical magnetic resonance imaging (MRI) at our hospital. We measured the diameters of the spinal canal and spinal cord from the 3rd cervical vertebra to the 1st thoracic vertebra (T1) at each level by using the patients’ cervical CT and MRI images. The spinal cord and spinal canal diameters were measured in the transverse plane of the cervical MRI and CT images, respectively. Results The spinal cord to spinal canal diameter ratio was the highest at the 4th and 5th cervical vertebrae (0.64 ± 0.07) and the lowest at T1 (0.55 ± 0.06, 99% CI [0.535, 0.565]. Conclusions Our findings suggest that the cord to canal transverse diameter ratio could be used as a reference to reduce direct spinal cord injuries during cervical epidural block under C-arm fluoroscopy. In the C-arm fluoroscopic image, if an imaginary line connecting the left and right innermost lines of the pedicles of T1 is drawn and if the needle is inserted into the outer one-fifth of the left and right sides, the risk of puncturing the spinal cord would be relatively reduced. |
| first_indexed | 2024-12-11T21:12:52Z |
| format | Article |
| id | doaj.art-f58fc2d398394d3ab62ab65ac6ead746 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-11T21:12:52Z |
| publishDate | 2022-08-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-f58fc2d398394d3ab62ab65ac6ead7462022-12-22T00:50:41ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632022-08-0175432333010.4097/kja.220068796Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patientsSo Young Lee0In Young Kim1Kyung Wook Jeong2Taeha Ryu3Sang Kyu Kwak4Jin Yong Jung5 Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, Korea Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, Korea Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, Korea Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, Korea Department of Medical Statistics, Daegu Catholic University School of Medicine, Daegu, Korea Department of Anesthesiology and Pain Medicine, School of Medicine Daegu Catholic University, Daegu, KoreaBackground If the proportion of the spinal cord in the epidural space can be determined under C-arm fluoroscopy during cervical epidural block, a safe entry point for the epidural needle can be established. The aim of this study was the measurement of the cord to canal transverse diameter ratio of each cervical spines. Methods We retrospectively evaluated the imaging data of 100 patients who underwent both cervical computed tomography (CT) and cervical magnetic resonance imaging (MRI) at our hospital. We measured the diameters of the spinal canal and spinal cord from the 3rd cervical vertebra to the 1st thoracic vertebra (T1) at each level by using the patients’ cervical CT and MRI images. The spinal cord and spinal canal diameters were measured in the transverse plane of the cervical MRI and CT images, respectively. Results The spinal cord to spinal canal diameter ratio was the highest at the 4th and 5th cervical vertebrae (0.64 ± 0.07) and the lowest at T1 (0.55 ± 0.06, 99% CI [0.535, 0.565]. Conclusions Our findings suggest that the cord to canal transverse diameter ratio could be used as a reference to reduce direct spinal cord injuries during cervical epidural block under C-arm fluoroscopy. In the C-arm fluoroscopic image, if an imaginary line connecting the left and right innermost lines of the pedicles of T1 is drawn and if the needle is inserted into the outer one-fifth of the left and right sides, the risk of puncturing the spinal cord would be relatively reduced.http://ekja.org/upload/pdf/kja-22006.pdfcervical cordcervical vertebraeepidural injectionsfluoroscopysafety managementspinal canalspinal cord injuriesthree-dimensional imaging |
| spellingShingle | So Young Lee In Young Kim Kyung Wook Jeong Taeha Ryu Sang Kyu Kwak Jin Yong Jung Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients Korean Journal of Anesthesiology cervical cord cervical vertebrae epidural injections fluoroscopy safety management spinal canal spinal cord injuries three-dimensional imaging |
| title | Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients |
| title_full | Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients |
| title_fullStr | Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients |
| title_full_unstemmed | Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients |
| title_short | Comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in Korean patients |
| title_sort | comparison between the coronal diameters of the cervical spinal canal and spinal cord measured using computed tomography and magnetic resonance imaging in korean patients |
| topic | cervical cord cervical vertebrae epidural injections fluoroscopy safety management spinal canal spinal cord injuries three-dimensional imaging |
| url | http://ekja.org/upload/pdf/kja-22006.pdf |
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