Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis.

Area of Science:

• Orthopedics
• Radiology
• Anatomy

Background:

• Uncovertebral joint hypertrophy is a primary cause of cervical neural foraminal stenosis (CNFS).
• The cross-sectional area of the uncinate process (UPA) is a key metric for assessing uncovertebral joint hypertrophy.

Purpose of the Study:

• To evaluate the relationship between CNFS and the uncinate process.
• To introduce and validate the uncinate process area (UPA) as a novel morphological parameter for diagnosing CNFS.

Main Methods:

• A retrospective observational study was conducted using neck CT scans from 146 patients with CNFS and 197 controls.
• The UPA was measured at the C5-6 intervertebral disc level using a picture archiving and communications system.

Main Results:

• Patients with CNFS had a significantly larger average UPA (29.97 mm²) compared to controls (15.52 mm²).
• Receiver operating characteristic curve analysis identified an optimal UPA cut-off of 21.15 mm² with high sensitivity (91.8%) and specificity (93.4%).
• The area under the curve was 0.972, indicating strong diagnostic performance.

Conclusions:

• The newly developed UPA is a sensitive and reliable parameter for assessing cervical neural foraminal stenosis.
• A hypertrophied UPA is strongly associated with an increased risk of CNFS.
• This finding is expected to assist diagnostic radiology in evaluating patients with CNFS.