Korean J Spine.  2014 Sep;11(3):178-182. 10.14245/kjs.2014.11.3.178.

Surface Landmarks do not Correspond to Exact Levels of the Cervical Spine: References According to the Sex, Age and Height

Affiliations
  • 1Spine and Joint Research Institute, Teun Teun Hospital, Seoul, Korea.
  • 2Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. nsyoon@gmail.com
  • 4Department of Anesthesiology and Pain Medicine, Inha University College of Medicine, Incheon, Korea.

Abstract


OBJECTIVE
A general orientation along the cervical spine could be estimated by external landmarks, and it was useful, quick and less exposable to radiation, but, sometimes it gave reference confusion of target cervical level. The authors reviewed the corresponding between the neck external landmarks and cervical levels.
METHODS
Totally 1,031 cervical lateral radiographs of different patients were reviewed in single university hospital. Its compositions were 534 of males and 497 females; 86 of second decades (10-19 years-old), 169 of third decades, 159 of fourth decades, 209 of fifth decades, 275 of sixth decades, and 133 of more than seventh decades (>60 years-old). Reference external landmarks (mandible, hyoid bone, thyroid cartilage, and cricothyroid membrane) with compounding factors were reviewed.
RESULTS
The reference levels of cervical landmarks were C2.13 with mandible angle, C3.54 with hyoid bone, C5.12 with thyroid cartilage, and C6.01 with cricothyroid membrane. The reference levels of cervical landmarks were differently observed by sex, age, and somatometric measurement (height) accordingly mandible angle from C1 to C3, hyoid bone from disc level of C2 and C3 to C5, thyroid cartilage from disc level of C3 and C4 to C7, and cricothyroid membrane from C4 to disc level of C7 and T1.
CONCLUSION
Surface landmarks only provide general reference points, but not correspond to exact levels of the cervical spine. Intraoperative fluoroscopy ensures a more precise placement to the targeted cervical level.

Keyword

External landmark; Cervical level; Mandible; Hyoid bone; Thyroid cartilage; Cricothyroid membrane

MeSH Terms

Female
Fluoroscopy
Humans
Hyoid Bone
Male
Mandible
Membranes
Neck
Spine*
Thyroid Cartilage
Full Text Links
  • KJS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr