Analysis of critical 3D imaging data of surrounding cervical nerves and bone markers in spinal endoscopic surgery

Determining the relationships among the epiphyseal ring, cervical nerve and vertebral pedicle isthmus via three-dimensional reconstruction can facilitate the precise removal of part of the uncinate process via spinal endoscopy, allowing safe cervical nerve decompression. C_3/4-C₇/T₁-related indices were measured in 26 patients with cervical spondylotic radiculopathy. The lowest point of epiphyseal ring posterior margin (LPER) was used as the key point for measuring indices, and the following distances were measured around the LPER: the anteroposterior distance from the LPER to the anterior margin of the cervical nerve at the position of the uncinate process tip (ANU), the vertical distance from the LPER to the inferior margin of the cervical nerve at the position of the uncinate process tip (VNU), the vertical distance from the LPER to the cervical nerve superior margin origin (VNS), the vertical distance from the LPER to the cervical nerve inferior margin origin (VNI), the left-right distance from the LPER to the dura mater lateral border (DLB), and the anteroposterior distance from the LPER to the vertebral pedicle isthmus lateral border (PLB). From C_3/4 to C₇/T_1, no significant differences in ANU were detected (P > 0.05), whereas significant differences in VNU, DLB, VNS, VNI, and PLB were detected (P < 0.05). No significant sex- or side-based index differences were detected (P > 0.05). No significant differences were found between VNU and VNI in each segment (P > 0.05). The LPER was marked, which grinds part of the uncinate process and osteophyte anteriorly (or posteriorly) and part of the posterior lateral osteophyte of the upper vertebral body upwards to achieve complete decompression of the pedicle and the ventral nerve of the outlet of the pedicle to the cervical nerve origin.