ABSTRACT
Introduction Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. To avoid long-term disability caused by irreversible spinal cord damage, quick diagnosis and treatment are required. To our knowledge, until recently, there has been no report or study evaluating the cervical canal stenosis and associated facet joint arthrosis as the major cause of neck pain, so the current study used computed tomography (CT) scans to determine the prevalence of cervical canal stenosis and facet joint osteoarthrosis in patients who presented with neck pain, including its relationship with age, sex, and cervical spinal levels (C3-C7). Methods The current clinical descriptive cross-sectional study was conducted in the Department of Anatomy and Radiodiagnosis at Santosh Medical College, Ghaziabad, for a period of 24 months among newly diagnosed outpatient department (OPD) cases of neck pain (18 years or older) with suspected cervical canal stenosis and facet joint arthrosis. Clinical history, patient-specific clinical examination, and relevant information were obtained in a structured data collection schedule through interviews during OPD hours. All of the participants underwent a CT scan of the cervical region. The independent factors (age, gender, height, and weight) were used in a multiple linear regression analysis of neck pain grading, Torg ratio (TR), and right and left facet joint degeneration, which were expressed as R-squared (R2) and adjusted R-squared (aR2). Statistical tests were executed at a 5% level of significance; an association was considered significant if the p-value was <0.05. Results A total of 83 subjects were enrolled in this study with equal representation from both sexes, i.e., males (49.4%) and females (50.6%). The transverse vertebral canal (T-VC) diameter was narrowest at the level of C3 (25.00 ± 1.13) and gradually increased at the level of C6 (25.18 ± 1.14) in this study. The mean TR of cervical vertebrae C3-C4 dropped gradually from C3 (0.78 ± 0.05) to C7 (0.76 ± 0.05) in this study. Severe left and right facet joint degeneration were observed in 13.3% and 10.5% of study subjects, respectively. In almost every subject, neck pain was a neurological symptom, so multiple linear regression analysis of neck pain grading was carried out with the independent variables (age, gender, height, and weight) and it was found to be not significant (R2 = 0.0617, aR2 = 0.0136, p = 0.2842). Conclusion The articulations of the posterior arch of the vertebrae are known as facet joints. They are a vital component of the vertebral column's structural stability. The superior and inner articular facets of the vertebrae are joined by these joints, which are encased in a fibrous capsule.
ABSTRACT
Multiple nerve variations were observed in the right gluteal region of a 62 year old female which includes origin, course and branching pattern of the sciatic and pudendal nerves. The sciatic nerve was formed by the L4, L5, S1 and S2 in the pelvis, whereas the pudendal nerve was contributed by the S3, S4 and S5. The pudendal was divided into medial and lateral divisions in the gluteal region. The lateral division had joined the sciatic nerve. High division of the pudendal nerve was observed and all its branches originated from the medial division of the pudendal nerve. The inferior rectal nerve passed through the sacrospinous ligament and formed a loop around the ischial spine. The dorsal nerve of the clitoris passed between the sacrospinous and sacrotuberous ligaments. Since iatrogenic injuries to these nerves may occur during surgery, a thorough knowledge of the variation anatomy of the sciatic and pudendal nerves can help to reduce post-operative complications. Moreover, variation anatomy knowledge might guide the radiologist, surgeons and other health professionals to diagnose and treat various neuralgia related to the perineum and gluteal region
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