Cervical intervertebral disc space narrowing and size of intervertebral foramina

Computer-assisted simulation of C4-C5, C5-C6, and C6-C7 intervertebral disc space narrowing was performed on 16 anatomic specimen cervical spines to determine the relationship of the cross sectional foraminal areas with the degree of narrowing of the cervical intervertebral disc space. Compared with normal foraminal area values, reduction of 20% to 30% of the foraminal area was found after 1 mm narrowing of the intervertebral disc spaces; reduction of 30% to 40% of the foraminal area was found after 2 mm narrowing of the intervertebral disc space; and reduction of 35% to 45% of the foraminal area was found after 3 mm narrowing of the intervertebral disc space. Statistically significant differences were found among the remaining cross sectional foraminal areas after different degrees of intervertebral disc space narrowing. Compression of the nerve root within the intervertebral foramina after the collapse of the intervertebral disc space cannot be ignored, and an appropriate surgical procedure to maintain the normal height of the disc space is essential. The size of the intervertebral foramen is related directly to the height of the intervertebral disc space. A 3-mm vertical reduction of the intervertebral disc space is associated more frequently with severe narrowing of the neuroforamen.