Anatomical parameters for assessing the cervical spine in normal conditions and with Kimmerle anomaly according to spiral computed tomography data

Background. Spiral computed tomography makes it possible to visualize in detail the anatomical structures of the spinal column and thereby makes it possible to create a regulatory framework for the subsequent assessment of the results of this research method.

Aim. To determine the anatomical parameters for assessing the cervical spine in normal conditions and with Kimmerle’s anomaly according to spiral computed tomography.

Material and methods. Spiral computed tomograms (in DICOM format) of the cervical spine of people aged 21 to 70 years of both sexes who do not have pathology of the cervical spine (n=54), as well as with Kimmerle anomaly (n=36), were studied. The width, height and length of the cervical vertebral bodies were analyzed, the longitudinal and transverse diameters of the atlas, the thickness of the anterior arch of the atlas were measured, the transverse-longitudinal index of the atlas, and the ratio of the width of the arch to the transverse diameter of the atlas were calculated. The parameters of the vaulted foramen were measured: the vertical and anteroposterior dimensions of the vaulted foramen and the thickness of the bone bridge. Processing of statistical material was carried out using the application package Excel and Statistica 10.0. To assess the normality of data distribution, the Kolmogorov–Smirnov test was used. The reliability of differences in the average values of independent samples was assessed using the nonparametric Mann–Whitney test in case of non-normal distribution of the initial data. Changes were considered significant at p <0.05.

Results. In those examined without pathology of the cervical spine and with Kimmerle's anomaly, the vertebral body height indicators were characterized by a decrease from CII to CIII, with a subsequent increase from CIII to CVII; the vertebral body width and length indicators increased from CII to CVII. According to spiral computed tomography data, in examined patients with Kimmerle anomaly, the average values [M (SD)] of the width of the posterior arch of the atlas on the right [8.8 (2.0) mm] and on the left [9.1 (1.7) mm], the ratio of the posterior arch to the transverse diameter of the atlas on the right [11.2 (2.6)%] and on the left [11.8 (2.2)%] was significantly (p <0.05) higher than similar sizes [7.5 (1.5) mm; 7.5 (1.1) mm; 9.6 (1.8)%; 9.6 (1.4)%, respectively] in people who did not have pathology of the cervical spine.

Conclusion. In patients with Kimmerle's anomaly, compared with the norm, there are differences in the width of the arch of the atlas, the ratio of the posterior arch to the transverse diameter of the atlas on the right and left.