Evaluation of the nutrient foramen as a suitable landmark in spinal surgery.

Abstract

The posterior cervical approach is a very popular surgical procedure. Because of the slope-shaped laminae, a suitable landmark for laminectomy, laminoplasty, and pedicle screw placement does not exist. We investigated the association between the nutrient foramen and spinal canal, and the safety of bone gutter placement using nutrient foramina for safe and effective spinal surgery. Observational SETTING: University Hospital PATIENT SAMPLES: Two hundred and sixty-six consecutive patients treated for cervical pathologies in our university hospital between January 2005 and December 2019. We identified the location of nutrient foramina and their anatomical association with the spinal canal using preoperative three-dimensional CT scanning. We studied the distance between each foramen and the spinal canal, and the angle of the nutrient foramen at each vertebral level. The nutrient foramina were always located outside the spinal canal, with an average distance of +3.06±1.74 mm. The lower the spinal level, the closer the nutrient foramen to the spinal canal. The nutrient foramen can be considered a reliable landmark when using the posterior cervical approach.