ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
Feasibility of total and partial uncinectomy during anterior cervical approach: MRI-based analysis of 176 patients regarding vertebral artery location.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Combined anterior-posterior osteotomy technique for correction of chin-on-chest deformity in ankylosing spondylitis: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
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6 authors at 1 institution in 1 country.
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Abstract
purposeTo determine the technical feasibility of uncinate process (UP) resection (uncinectomy) during anterior cervical approach with risk-avoidance of vertebral artery (VA) injury.
methodsOne hundred and seventy-six magnetic resonance imaging images with cervical spondylosis were evaluated. The diameter between UP and VA (UP-VA distance), the presence of a fat plane, and the VA's anterior-posterior position relative to UP (anterior[A], middle[M], posterior[P]) at C3-4 to C6-7 segments were investigated. Subsequently, easy-to-use classifications were developed according to the feasibility of total and partial uncinectomy. Total uncinectomy: easy (distance: > 2 mm); moderate (distance: ≤ 2 and fat plane: +); advanced (no fat plane). Partial uncinectomy: easy (distance: > 2 mm and P, A, or M position); moderate (distance: ≤ 2; fat plane: + and P position), and advanced (no fat plane and P position).
resultsUP-VA distance of C5-6 on the right side (left/right: 0.41/0.31 mm) was the smallest. The ratio of no fat plane of C5-6 (46.6%/49.4%) was the highest. C5-6 had a high rate of P position (7.4%/8.5%) while C6-7 had a high rate of A position (19.3%/18.2%). More than 90% individuals were classified as easy for partial uncinectomy at any vertebral segment (C3-7), while more than 30% were classified as advanced at C4-7 with the highest rate at C5-6 for total uncinectomy.
conclusionWhen performing uncinectomy during the anterior cervical approach, the C5-6 segment may be at the greatest risk of VA injury. Hence, preoperative MR images should be thoroughly evaluated to avoid VA injury.
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