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Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels

STUDY DESIGN: A descriptive experimental study. PURPOSE: The purpose of this study was to describe the reliability and accuracy of palpable anterior neck landmarks (angle of the mandible, hyoid bone, thyroid cartilage, and cricoid cartilage) for the identification of cervical spinal levels in a slig...

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Autores principales: Siribumrungwong, Koopong, Sinchai, Chitpon, Tangtrakulwanich, Boonsin, Chaiyamongkol, Weera
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821937/
https://www.ncbi.nlm.nih.gov/pubmed/29503686
http://dx.doi.org/10.4184/asj.2018.12.1.80
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author Siribumrungwong, Koopong
Sinchai, Chitpon
Tangtrakulwanich, Boonsin
Chaiyamongkol, Weera
author_facet Siribumrungwong, Koopong
Sinchai, Chitpon
Tangtrakulwanich, Boonsin
Chaiyamongkol, Weera
author_sort Siribumrungwong, Koopong
collection PubMed
description STUDY DESIGN: A descriptive experimental study. PURPOSE: The purpose of this study was to describe the reliability and accuracy of palpable anterior neck landmarks (angle of the mandible, hyoid bone, thyroid cartilage, and cricoid cartilage) for the identification of cervical spinal levels in a slight neck-extended position as in anterior approach cervical spinal surgery. OVERVIEW OF LITERATURE: Standard, palpable anatomical landmarks for the identification of cervical spinal levels were described by Hoppenfeld using the midline palpable anterior structures (angle of the mandible [C2 body], hyoid bone [C3 body], thyroid cartilage [C4–C5 disc], cricoid cartilage [C6 body], and carotid tubercle [C6 body]) to determine the approximate level for skin incisions. However, in clinical practice, patients are positioned with a slight neck extension to achieve cervical lordosis. This positioning (neck extension) may result in changes in the locations of anatomical landmarks compared with those reported in previous studies. METHODS: This experimental study was conducted on 96 volunteers. Each volunteer was palpated for locating four anatomical landmarks three times by three different orthopedic surgeons. We collected data from the level of the vertebral body or the vertebral disc matching the surface anatomical landmarks from the vertical reference line. RESULTS: Accuracy of the angle of the mandible located at the C2 vertebral body was 95.5%, the hyoid bone located at the C2/3 intervertebral disc was 51.7%, the thyroid cartilage located at the C4 vertebral body was 42%, and the cricoid cartilage located at the C5/6 intervertebral disc was 43.4%. CONCLUSIONS: With the neck in a slightly extended position to achieve cervical lordosis, the angle of the mandible, the hyoid bone, the thyroid cartilage, and the cricoid cartilage were most often located at the C2 body, the C2/3 disc, the C4 body, and the C5/6 disc, respectively. The angle of the mandible and the hyoid bone are highly reliable surface anatomical landmarks for the identification of cervical spinal levels than the thyroid cartilage and the cricoid cartilage.
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spelling pubmed-58219372018-03-02 Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels Siribumrungwong, Koopong Sinchai, Chitpon Tangtrakulwanich, Boonsin Chaiyamongkol, Weera Asian Spine J Clinical Study STUDY DESIGN: A descriptive experimental study. PURPOSE: The purpose of this study was to describe the reliability and accuracy of palpable anterior neck landmarks (angle of the mandible, hyoid bone, thyroid cartilage, and cricoid cartilage) for the identification of cervical spinal levels in a slight neck-extended position as in anterior approach cervical spinal surgery. OVERVIEW OF LITERATURE: Standard, palpable anatomical landmarks for the identification of cervical spinal levels were described by Hoppenfeld using the midline palpable anterior structures (angle of the mandible [C2 body], hyoid bone [C3 body], thyroid cartilage [C4–C5 disc], cricoid cartilage [C6 body], and carotid tubercle [C6 body]) to determine the approximate level for skin incisions. However, in clinical practice, patients are positioned with a slight neck extension to achieve cervical lordosis. This positioning (neck extension) may result in changes in the locations of anatomical landmarks compared with those reported in previous studies. METHODS: This experimental study was conducted on 96 volunteers. Each volunteer was palpated for locating four anatomical landmarks three times by three different orthopedic surgeons. We collected data from the level of the vertebral body or the vertebral disc matching the surface anatomical landmarks from the vertical reference line. RESULTS: Accuracy of the angle of the mandible located at the C2 vertebral body was 95.5%, the hyoid bone located at the C2/3 intervertebral disc was 51.7%, the thyroid cartilage located at the C4 vertebral body was 42%, and the cricoid cartilage located at the C5/6 intervertebral disc was 43.4%. CONCLUSIONS: With the neck in a slightly extended position to achieve cervical lordosis, the angle of the mandible, the hyoid bone, the thyroid cartilage, and the cricoid cartilage were most often located at the C2 body, the C2/3 disc, the C4 body, and the C5/6 disc, respectively. The angle of the mandible and the hyoid bone are highly reliable surface anatomical landmarks for the identification of cervical spinal levels than the thyroid cartilage and the cricoid cartilage. Korean Society of Spine Surgery 2018-02 2018-02-07 /pmc/articles/PMC5821937/ /pubmed/29503686 http://dx.doi.org/10.4184/asj.2018.12.1.80 Text en Copyright © 2018 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Siribumrungwong, Koopong
Sinchai, Chitpon
Tangtrakulwanich, Boonsin
Chaiyamongkol, Weera
Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title_full Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title_fullStr Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title_full_unstemmed Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title_short Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels
title_sort reliability and accuracy of palpable anterior neck landmarks for the identification of cervical spinal levels
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821937/
https://www.ncbi.nlm.nih.gov/pubmed/29503686
http://dx.doi.org/10.4184/asj.2018.12.1.80
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