Assessment of Anteroposterior Diameter and Interpedicular Distance in the Approximation of Cervical Spinal Canal Area.

Rationale and objectives This study seeks to generate a model based on two linear measurements, anteroposterior (AP) diameter and interpedicular (IPD) distance, to approximate the cervical central canal (CCC) area in a non-pathologic patient population by employing area calculations of shapes such as ellipse, rectangle, and triangle. Secondarily, this study aims to generate second-order approximations (SOAs), using the aforementioned shape approximations, to increase the utility of this linear measurement-based model. Methods The authors reviewed medical and radiographic records of patients aged 18-35 who received computed tomography (CT) imaging of the cervical spine to collect AP diameter, IPD distance, and area of the CCC from C2-3 to C6-7. Subsequently, shape approximations were calculated for each patient at all cervical spine levels. Lastly, SOAs were generated by combining optimal ratios of shape approximations to improve the statistical reliability of approximations. Results The ellipse shows the closest approximation to manual measurements of the individual shape approximations. Percent error analysis demonstrated the superiority of the ellipse, followed by the rectangle, and lastly the triangular approximation. The highest correlation of approximations was observed at C6-7. All individual shape approximations demonstrated statistical differences from manual measurements. SOAs combining ellipse and rectangle measurements demonstrated superior accuracy and were not statistically different from manual measurements. Conclusion Individual shape approximations based on AP diameter and IPD distance show some value as a model for the assessment of the CCC area. SOAs demonstrated greater utility than individual shape approximations and show promise as a linear measurement-based tool to assess the CCC area.

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Human subjects: Consent was obtained or waived by all participants in this study. Loma Linda University Health Human Research and Compliance issued approval 5240112. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.