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Quantitative changes in the cervical neural foramen resulting from axial traction: in vivo imaging study
Jiayong Liu1, Nabil A Ebraheim, Chris G Sanford
1Department of Orthopaedic Surgery, Medical University of Ohio, 3065 Arlington Avenue, Toledo, OH 43614, USA. jialiu@meduohio.edu
Background Context:
Cervical traction has a long history as a method of conservative treatment for cervical spine diseases. However, information on quantitative changes in the cervical neural foramen resulting from axial traction in vivo is lacking.
Purpose:
To quantitatively evaluate the changes in the neural foramen of the cervical spine during axial traction in vivo.
Study Design:
A prospective radiographic analysis of the cervical neural foramen of adult volunteers.
Patient Sample:
Fifteen healthy volunteers (10 men, 5 women) without any history of cervical spine disease.
Outcome Measures:
The changes in cervical cross-sectional foraminal areas and heights were measured.
Methods:
Cervical magnetic resonance (MR) images of the volunteers were taken at the neutral position and were reconstructed in the oblique plane perpendicular to the long axis of each neural foramen from the C2-3 to the C6-7 level. The changes in the neural foraminal dimensions at incremental axial traction forces (0, 5, 10, and 15 kg) were analyzed.
Results:
After each 5-kg incremental increase in traction weight, there was a significant (p value less than .05) increase in area and height of the intervertebral foramen compared with the position in which no weight was applied. There was an average increase of 5.81%, 16.56%, and 18.9% in the foraminal area and an average increase of 3.75%, 8.67%, and 10.43% in foraminal height compared with the position with no weight at traction of 5, 10, and 15 kg, respectively. There was no statistically significant difference for the increase in foraminal area and height from 10 to 15 kg of traction (p value greater than .05).
Conclusions:
There was a significant increase in intervertebral foraminal area and height after each 5-kg increment in traction weight compared with the position in which no weight was applied. From 10 to 15 kg of traction, there was no significant change in the foraminal area and height.
