Morphometry of the Cervical Uncinate Process and its Relation to the Vertebral Artery in a Select Kenyan Population: A Computed Tomography Study

Authors

  • Felix Mburu Njoroge University of Nairobi, Department of Human Anatomy
  • Kirsteen Awori
  • Jeremiah Munguti
  • Philip Mwachaka

Keywords:

uncinate process, vertebral artery, Kenya

Abstract

Background: The cervical uncinate process (UP) is of clinical importance due to its proximity to vital neurovascular structures that are at risk of compression as well as iatrogenic injury during anterior cervical spine surgery. This study therefore aimed to describe the morphometric features of the UP and its relation to the vertebral artery. Materials and Methods: This descriptive cross-sectional study was carried out at the Department of Radiology, Kenyatta National Hospital. One hundred contrast-enhanced neck CT scan images were obtained in coronal reformat, and the following parameters were analyzed using NeusoftTM software: the UP extents, height, width, angle of inclination, and uncovertebral artery distance. Results: The UP was observed caudally at C7 (100%), T1 (49%), and T2 (1%). Sex, age, vertebral level, as well as side differences were observed in the aforementioned parameters. Conclusion: The variations in the UP morphometry emphasize the utility of CT imaging of the UP in order to reduce the incidence of surgical complications as well as in the diagnosis of related pathologies. The knowledge of the vertebral artery’s proximity to the UP is useful during procedures of the cervical spine in order to reduce the incidence of iatrogenic injury to the artery.

KEY WORDS: uncinate process; vertebral artery; radiological.

References

Hartman J. Anatomy and clinical significance of the uncinate process and uncovertebral joint: A comprehensive review. Clin Anat N Y N. 2014 Apr;27(3):431–40.

Güvençer M, Naderi S, Men S, Sayhan S, Tetik S. Morphometric evaluation of the uncinate process and its importance in surgical approaches to the cervical spine: a cadaveric study. Singapore Med J. 2016 Oct;57(10):570–7.

Raveendranath V, Kavitha T, Umamageswari A. Morphometry of the Uncinate Process, Vertebral Body, and Lamina of the C3–7 Vertebrae Relevant to Cervical Spine Surgery. Neurospine. 2019 Dec;16(4):748–55.

Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M. Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br. 1993 May;75(3):410–5.

Othman YA, Verma R, Qureshi SA. Artificial disc replacement in spine surgery. Ann Transl Med [Internet]. 2019 Sep

Stull KE, Tise ML, Ali Z, Fowler DR. Accuracy and reliability of measurements obtained from computed tomography 3D volume rendered images. Forensic Sci Int. 2014 May;238:133–40.

Tulsi RS, Perrett LV. The Anatomy and Radiology of the Cervical Vertebrae and the Tortuous Vertebral Artery. Australas Radiol. 1975 Sep;19(3):258–64.

Hayashi K, Yabuki T. Origin of the uncus and of Luschka’s joint in the cervical spine. J Bone Joint Surg Am. 1985 Jun;67(5):788–91.

Herniated Cervical Disc, herniated disc, ruptured cervical disc, bulging disc, neck surgery, acdf [Internet]. [cited 2021 Jul 7]. Available from: https://mayfieldclinic.com/pe-hcdisc.htm

Prolapsed Intervertebral Disc in an African Population: Kenyan Experience | East African Orthopaedic Journal [Internet]. [cited 2021 Jun 16].

Pait TG, Killefer JA, Arnautovic KI. Surgical anatomy of the anterior cervical spine: the disc space, vertebral artery, and associated bony structures. Neurosurgery. 1996 Oct;39(4):769–76.

Bozbuğa M, Oztürk A, Ari Z, Bayraktar B, Sahinoğlu K, Gürel I. Surgical anatomic evaluation of cervical uncinate process for ventral and ventrolateral subaxial decompression. Okajimas Folia Anat Jpn. 1999 Oct;76(4):193–6.

Russo VM, Graziano F, Peris-Celda M, Russo A, Ulm AJ. The V2 segment of the vertebral artery: anatomical considerations and surgical implications: Laboratory investigation. J Neurosurg Spine. 2011 Dec;15(6):610–9.

Uğur HÇ, Uz A, Attar A, Tekdemir İ, Egemen N, Elhan A. Anatomical projection of the cervical uncinate process in ventral, ventrolateral, and posterior decompressive surgery. J Neurosurg Spine. 2000 Oct 1;93(2):248–51.

Güvençer M, Naderi S, Men S, Sayhan S, Tetik S. Morphometric evaluation of the uncinate process and its importance in surgical approaches to the cervical spine: a cadaveric study. Singapore Med J. 2016 Oct;57(10):570–7.

Post NH, Cooper PR, Frempong-Boadu AK, Costa ME. Unique features of herniated discs at the cervicothoracic junction: clinical presentation, imaging, operative management, and outcome after anterior decompressive operation in 10 patients. Neurosurgery. 2006 Mar;58(3):497–501; discussion 497-501.

Christ B, Huang R, Wilting J. The development of the avian vertebral column. Anat Embryol (Berl). 2000 Sep;202(3):179–94.

Senthelal S, Li J, Goyal A, Bansal P, Thomas MA. Arthritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021

Rudy IS, Poulos A, Owen L, Batters A, Kieliszek K, Willox J, et al. The correlation of radiographic findings and patient symptomatology in cervical degenerative joint disease: a cross-sectional study. Chiropr Man Ther. 2015 Feb 9;23(1):9.

Clarke BL, Khosla S. Androgens and Bone. Steroids. 2009 Mar;74(3):296–305.

Kim S-H, Lee JH, Kim JH, Chun KS, Doh JW, Chang JC. Anatomical Morphometric Study of the Cervical Uncinate Process and Surrounding Structures. J Korean Neurosurg Soc. 2012 Oct;52(4):300–5.

Han H-C. Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms. J Vasc Res. 2012 May;49(3):185–97.

Magklara E-P, Pantelia E-T, Solia E, Panagouli E, Piagkou M, Mazarakis A, et al. Vertebral artery variations revised: origin, course, branches and embryonic development. Folia Morphol. 2021;80(1):1–12.

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Published

27-02-2023

How to Cite

1.
Mburu Njoroge F, Awori K, Munguti J, Mwachaka P. Morphometry of the Cervical Uncinate Process and its Relation to the Vertebral Artery in a Select Kenyan Population: A Computed Tomography Study. EAJNS [Internet]. 2023 Feb. 27 [cited 2024 Dec. 3];2(1):21-30. Available from: https://theeajns.org/index.php/eajns/article/view/36

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