Radiological imaging technique
For a reliable assessment of structural changes in uncovertebral arthrosis, computed tomography (CT) of the cervical spine is used. This method allows for a detailed study of bone anatomy and the detection of even minimal degenerative transformations.
A comprehensive analysis of the pathology requires studying a series of images in multiple planes. The standard diagnostic protocol includes the following projections:
- Axial (axial) — transverse slices for assessing the structures of the spinal canal and foramina.
- Sagittal (sagittal) — longitudinal slices demonstrating the spinal column from the side.
- Coronal / frontal (coronal) — front or rear view, optimal for symmetrical assessment of the processes.
- 3D CT reconstruction (3D computed tomography) — a three-dimensional image allowing for a clear visual assessment of spatial deformations of bone structures.
Radiological presentation
The main diagnostic sign of uncovertebral arthrosis on computed tomograms is the presence of osteophytes. These marginal bone outgrowths are localized in the area of the uncinate processes (processus uncinatus), altering their normal anatomical shape and increasing their volume.
An important characteristic of the pathological process is its asymmetry. When analyzing tomograms, unevenness of degenerative changes is frequently revealed. In the diagnostic case under consideration, bone outgrowths are predominantly expressed on the right side of the cervical spine, whereas on the left side, pathological manifestations are recorded to a significantly lesser extent.
Complications and level of lesion
The proliferation of osteophytes of the uncinate processes inevitably affects adjacent anatomical spaces. The main radiological complication clearly visualized on CT is stenosis.
As a result of bone tissue hypertrophy, a significant narrowing of the right intervertebral foramen (foramen intervertebrale) occurs. This is a critical zone, the narrowing of which is a direct consequence of asymmetric right-sided osteophyte growth.
Topographically, the described degenerative changes and secondary stenosis are recorded at a specific level of the cervical spine — between the C5 and C6 vertebrae.
Briefly: answers to topical questions
What anatomical structures pass through the intervertebral foramen of the cervical spine?
According to sources, in foraminal lesions, the spinal nerve root exiting at the given level may be compressed within the intervertebral foramen.
With uncovertebral degeneration, osteophytes form on the uncinate processes with age, leading to the narrowing of the intervertebral and transverse foramina (foramina) and potentially causing compression of the spinal nerve root and the vertebral artery.
Foraminal narrowing is most commonly caused by uncovertebral osteophytes; less frequently, the cause is facet joint degeneration and disc herniation.
What are the uncovertebral joints (joints of Luschka) in terms of normal anatomy?
Uncovertebral joints (joints of Luschka / Luschka joints) are anatomical structures present from the C2–C3 to the C6–C7 levels.
They are formed by the superior projections of the lateral surfaces of the C3–C7 vertebral bodies, which are called uncinate processes (uncinate processes). These processes articulate with the vertebra above. At the C7 level, they may be absent or hypoplastic.
From the perspective of normal anatomy and biomechanics, these joints develop with age and perform the following functions:
- Provision of mobility — participate in flexion and extension of the cervical spine.
- Limitation of movement — limit lateral movements.
- Protective function — protect against lateral and foraminal intervertebral disc herniations.
At which levels of the cervical spine is uncovertebral arthrosis most frequently localized?
The sources do not specify the exact levels at which uncovertebral arthrosis is most frequently localized.
The anatomical boundaries of the uncovertebral joints are indicated: they are present from the C2–C3 to the C6–C7 levels and are formed by the superior projections of the lateral surfaces of the C3–C7 vertebral bodies — the uncinate processes (uncinate processes), which articulate with the vertebra above. At the C7 level, these processes may be absent or hypoplastic; sometimes they are traced up to T1.
In the presented clinical example of uncovertebral arthrosis, narrowing of the intervertebral foramen is recorded at the C5–C6 level.
Remember the connection: UNcovertebral arthrosis affects UNcinate (hook-shaped — processus uncinatus) processes.
Class and exam questions
In which projections is uncovertebral arthrosis evaluated on CT?
For assessment, axial, sagittal, coronal (frontal) projections, as well as three-dimensional (3D) CT reconstruction are used.
Which vertebra structures are primarily altered in this pathology?
Pathological changes (osteophyte formation) affect the uncinate processes (processus uncinatus).
To which anatomical complication does osteophyte proliferation lead?
Osteophytes cause significant narrowing of the intervertebral foramen (foramen intervertebrale).
What else to study on this topic
- Technique of 3D CT reconstructions of the cervical spine
- Comparative analysis of axial and coronal projections in stenosis
- Anatomical structure of the uncinate processes (processus uncinatus)
- Radiological criteria for assessing intervertebral foramina
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