Determining Accessibility of Anterior Cervicothoracic Spine Based on Age and Gender: Radiographic Analysis of...

Objective  The approachability of the cervicothoracic region anteriorly based on age and gender, and the possibility of anatomic variances in different geographic populations have not been previously investigated. The aim of the present work was to perform a radiographic analysis of Brazilian patients to assess anterior approachability of the cervicothoracic junction based on age and gender. Methods  Retrospective radiographic analysis of 300 computed tomography scans. Patients were separated based on age and gender. The radiographic parameters studied were: horizontal level above the sternum (HLS), vertebral body angle (VBA), intervertebral disc line (IDL), and intervertebral disc line angulation (IDLA). Results  The most frequent HLS and IDL were T2 (34.3%) and C7-T1 (46%) respectively. Vertebral body angleand IDLA had average values of 18 ± 8.94 and 19 ± 7.9 degrees, respectively. Males had higher values in both IDLA ( p  = 0.003) and VBA ( p  = 0.02). Older groups had higher values in both IDLA ( p  = 0.01) and VBA ( p  = 0.001). No differences were observed in HLS between gender ( p  = 0.3) or age groups ( p  = 0.79). No differences were seen in IDL between gender groups ( p  = 0.3); however, the older group had a more caudal level than the younger groups ( p  = 0.12). Conclusions  Compared to other populations, our sample had a more cephalad IDL and HLS. Vertebral body angle and IDLA were higher in males and higher angles for VBA and IDLA were shown for older groups. Intervertebral disc line was more caudal with aging.