Morphology of the cervical lamina and spinous processes on CT in northeast China: A retrospective observational study correlating anatomical parameters with cervical spondylosis

To investigate whether specific morphological parameters of the cervical vertebral lamina and spinous processes are associated with cervical spondylosis (CS) in a northeast Chinese population. This retrospective observational study reviewed cervical computed tomography images acquired between August 2022 and August 2025. Patients were divided into a CS group and a control group according to clinical diagnosis. Seven parameters from C3 to C7 were measured: lamina length, lamina width (LW), laminar transverse angle (LTA), laminar sagittal diameter (LSD), spinous process length, spinous process thickness, and caudal angulation of the spinous process. Intra- and inter-observer reliability were assessed using intraclass correlation coefficients. Paired t -tests compared left and right sides; independent samples t -tests compared groups. Normality and homogeneity of variance were verified. A total of 100 patients (50 per group) were included. Intra-/inter-observer intraclass correlation coefficientss were > 0.85 for all parameters. No significant left-right differences were found. Compared with controls, the CS group exhibited significantly greater LW and LTA at all levels (e.g., C3 LW: 4.99 ± 0.92 mm vs 4.17 ± 0.71 mm, P < .001; C3 LTA: 54.96 ± 2.90° vs 53.70 ± 2.00°, P = .014) and significantly smaller LSD at all levels (e.g., C3 LSD: 4.76 ± 0.49 mm vs 5.64 ± 0.46 mm, P < .001). Lamina length did not differ between groups. For spinous processes, C7 spinous process length was significantly longer in the CS group (23.19 ± 0.98 mm vs 21.89 ± 0.92 mm, P < .001), and C5 spinous process thickness was significantly thinner (6.51 ± 1.01 mm vs 7.14 ± 0.91 mm, P = .001). Caudal angulation of the spinous process differed significantly at C3 and C4 ( P < .05) but not at C5 to C7. Distinct morphological features of the cervical lamina and spinous processes (particularly increased LW and LTA, reduced LSD, elongated C7 spinous process, and thinner C5 spinous process) are significantly associated with CS. These parameters may serve as anatomical risk indicators and support personalized posterior surgical planning.