Incidence and Skeletal Features of Developmental Cervical and Lumbar Spinal Stenosis

Abstract

Study Design: Cross-sectional study.Purpose: To report the prevalence and relationship of developmental cervical and lumbar spinal stenosis (DCSS and DLSS) with the bone parameters of the skull and extremities.Overview of Literature: DCSS and DLSS are found occasionally in daily practice. DCSS and DLSS can cause compressive myelopathy, radiculopathy, and cauda equina syndrome; however, data on their prevalence and correlation with skull and skeletal extremity profiles is scarce.Methods: A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4–C6) and third to fifth lumbar vertebrae (L3–L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses.Results: The age was 22–93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the “no spinal stenosis sample,” DSS (−), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (<i>p</i><0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum.Conclusions: DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.

Identification of L5 vertebra on lumbar spine radiographs using deep learning

“…19 The selection of incorrect lumbar spine levels increases the likelihood of identifying the wrong lumbar nerve root, which can result in the treatment of incorrect lumbar segment levels during interventional or surgical procedures. 20 Historically, several methods for accurately identifying the lumbar spine level have been reported, including a method using the 12th rib, iliolumbar ligament, kidney level, and craniocaudal level on whole-spine radiographs. However, conventional methods are not accurate; [21][22][23] spine physicians have therefore endeavored to develop further methods for accurately identifying lumbar spine segment numbers.…”

Identification of L5 Vertebra on Lumbar Spine Radiographs Using Deep Learning

“…The accurate determination of the lumbar spine segment is of great importance [18]. Lumbar spine pathology and related clinical symptoms are signi cantly associated with speci c lumbar nerve roots, which can be localized to the lumbar spine level [19]. Thus, selecting improper lumbar spine levels makes identifying the wrong lumbar nerve root likely, resulting in the management of improper lumbar segment levels during interventional or surgical procedures [20].…”

Letter to the Editor: Incidence and Skeletal Features of Developmental Cervical and Lumbar Spinal Stenosis

“…We were intrigued by the article by Kasai et al [ 1 ], which found that a small skull, small transverse diameter of the foramen magnum, and the small orbital bone were significantly correlated with developmental cervical spinal stenosis (DCSS). However, we have some concerns about this paper.…”