The 68th
Scientific Meeting
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| 19S-002 |
Uncinate Process Area as A New Sensitive Morphological Parameter to Predict Cervical Spinal Stenosis
한양대학교 의과대학 마취통증의학교실, 가톨릭관동대학교 의과대학 마취통증의학교실1
Background: Hypertrophy of the uncovertebral joint has been considered as a major cause of cervical spinal stenosis (CSS).The cross-sectional area of the uncinate process is a key morphologic parameter in the identification of uncovertebral joint hypertrophy. To evaluate connection between CSS and the uncinate process, wedevised a new morphological parameter, the uncinate process area (UPA).
Objective: We hypothesized that the UPA is an important morphologic parameter in the diagnosis of CSS.
Study Design: Retrospective observational study.
Setting: The single center study in Incheon, Republic of Korea.
Methods: UPA data were collected from 146 patients with CSS and197 control subjects who underwent neck computed tomography (CT) as part of a routine medical examination. Neck CT images were obtained from all subjects. The whole cross-sectional area of the bone margin of the uncinate process was measured at the C5-6intervertebral disc level on CT scans using a picture archiving and communications system.
Results: The average UPA was 15.52 mm2 in the control group and29.97 mm2 in the CSS group. CSS group displayed significantly higher UPA levels (p<0.001). Regarding the validity of the UPA as a predictor of CSS, receiver operating characteristic curve analysis revealed an optimal cut-off point for the UPA of 21.15 mm2, with 91.8 % sensitivity, 93.4% specificity, and an area under the curve of 0.972 (95% CI,0.956-0.989) in the CSS group.
Limitations: Anatomically, the UP is located on the superior lateral surfaces to the C3-7 cervical vertebral bodies. However, we focused on C5-6 uncovertebral joint level, because many previous studies revealed C6 UP is greatest height among UP and C5-6 uncovertebral joint hypertrophy is main cause of CSS.
Conclusions: The newly devised UPA is a sensitive parameter for assessing CSS. A higher UPA is associated with higher possibility of CSS. We think that this result will be helpful for diagnostic radiology in evaluating patients with CSS.
Institutional Review Board (IRB) approval number: IS16RISI0002
Keywords: Uncinate process area, Cervical spinal stenosis, Uncovertebral joint hypertrophy, optimal cut-off point, cross- sectional area
Objective: We hypothesized that the UPA is an important morphologic parameter in the diagnosis of CSS.
Study Design: Retrospective observational study.
Setting: The single center study in Incheon, Republic of Korea.
Methods: UPA data were collected from 146 patients with CSS and197 control subjects who underwent neck computed tomography (CT) as part of a routine medical examination. Neck CT images were obtained from all subjects. The whole cross-sectional area of the bone margin of the uncinate process was measured at the C5-6intervertebral disc level on CT scans using a picture archiving and communications system.
Results: The average UPA was 15.52 mm2 in the control group and29.97 mm2 in the CSS group. CSS group displayed significantly higher UPA levels (p<0.001). Regarding the validity of the UPA as a predictor of CSS, receiver operating characteristic curve analysis revealed an optimal cut-off point for the UPA of 21.15 mm2, with 91.8 % sensitivity, 93.4% specificity, and an area under the curve of 0.972 (95% CI,0.956-0.989) in the CSS group.
Limitations: Anatomically, the UP is located on the superior lateral surfaces to the C3-7 cervical vertebral bodies. However, we focused on C5-6 uncovertebral joint level, because many previous studies revealed C6 UP is greatest height among UP and C5-6 uncovertebral joint hypertrophy is main cause of CSS.
Conclusions: The newly devised UPA is a sensitive parameter for assessing CSS. A higher UPA is associated with higher possibility of CSS. We think that this result will be helpful for diagnostic radiology in evaluating patients with CSS.
Institutional Review Board (IRB) approval number: IS16RISI0002
Keywords: Uncinate process area, Cervical spinal stenosis, Uncovertebral joint hypertrophy, optimal cut-off point, cross- sectional area
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