Objective: we will use micro-computed tomography to scan the adult lower cervical vertebrae and measure structural and morphological parameters. Then we will analyze the data, summarize trabecular distributing patterns, and provide the anatomical theoretical basis for clinical and surgical treatment strategies.
Methods: Micro-computed Tomography scans were performed on 31 sets of lower cervical vertebrae (155 vertebrae) to observe the morphological characteristics and direction of trabeculae in the lower cervical vertebrae by outlining and reconstructing the regions of interest and to calculate the variation laws of the microstructure in the regions of interest to reveal their structural characteristics and weak areas.
Results: The images showed that the trabeculae in the lower cervical pedicle near the medial and lateral cortices were relatively dense, and their bone plates were lamellar. There were cavities between the superior and inferior articular processes where the ossification centers had not been absorbed after ossified. The lamellar trabeculae in the vertebral plates near the cortical bones were only 1-2 layers, extended and transformed into rod-shaped trabeculae in a radial shape toward the medullary space. The lamellar trabeculae of the vertebral plate extend over the spinous process near the cortical bone. The statistical results of the trabeculae's morphological parameters showed significant differences in bone volume fraction values among the four parts (P<0.05). There were substantial differences in BS/BV, except for no differences between the pedicle and the vertebral plate (P<0.05). There was a significant difference in trabecular pattern factor values between the articular process, the spinous process, and the vertebral plate (P<0.05) and a significant difference between the pedicle, the spinous process, and the vertebral plate (P<0.05). There were no significant differences in trabecular bone thickness and trabecular space values among the four parts (P<0.05).
Conclusion: The anatomical microstructural perspective confirms that the optimal choice is internal fixation via the pedicle. If using pedicle screws, the nail tract needs to be placed into the spinous process to increase its holding power and resistance to extraction.