Cervical Transforaminal Axis Measured by MRI and Its Relation to the Internal Jugular Vein, Internal Carotid Artery and Vertebral Artery

Kang, Sang Soo; Choi, Eun Seon; Park, Jun Hee; Hong, Seong Jun; Kim, Il Seok; Yun, Yeong Jun; Shin, Keun Man

Abstract

BACKGROUND: The safety of cervical transforaminal epidural block has been the subject of debate, therefore, this study was conducted to measure the angle of the cervical transforaminal axis and to investigate its relationship to the internal jugular vein, internal carotid artery and vertebral artery.
METHODS
One hundred cases of cervical MRI were reviewed. The angle between a line passing through the center of the vertebral body and spinous process and a line passing through the center of the lamina in C3-4, C4-5 and C5-6 was measured and designated as A-degree. Additionally, we drew a line at the back of the vertebral artery that ran parallel to a line passing through the center of the lamina, which was presented as A-line. We then examined the distribution of the area in which the internal jugular vein and the internal carotid artery were located.
RESULTS
The mean values of the A-degree in C3-4, C4-5 and C5-6 were 53.5 +/- 4.3, 54.2 +/- 4.6 and 54.3 +/- 4.8, respectively. There were no statistically significant differences among age groups or vertebral levels (ANOVA test, P > 0.05). The A-line was distributed primarily throughout zone 3, 4, and 5 in C3-4 and zone 5 in C4-5 and C5-6.
CONCLUSIONS
The results of this study indicate that the mean values of A-degree were not statistically different among each age group and each vertebral level. However, the A-line may be located in the zone in which the internal jugular vein and the internal carotid artery lie and individual differences in the A-degree remain.