Evaluation of thoracic pedicle morphometry in a Chinese population using 3D reformatted CT

Zhuang, Zerui; Xie, Zeyu; Ding, Shuzhe; Chen, Yu‐Chun; Luo, Jun; Wang, Xinjia; Kong, Kangmei

doi:10.1002/ca.21265

Cited by 15 publications

(10 citation statements)

References 37 publications

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“…The parameters measured in the current study for each subject included pedicle width and pedicle length. The measurement method is described below [29,36]. The guideline was defined as the straight-line perpendicular to the axis of the vertebra that passed through the anterior tip of the vertebral canal.…”

Section: Measurement Of Morphologic Features Of the Pediclementioning

confidence: 99%

What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study

Gao

Chen

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Our study can help surgeons perform preoperative assessments in females with adolescent idiopathic scoliosis, and with preoperative and intraoperative management for difficult pedicle screw placement. In particular, our results suggest that surgeons should exercise increased vigilance when selecting pedicle screw dimensions, especially in the concave aspect of the mid-thoracic curve, to avoid cortical breeches. Future studies should evaluate other Lenke types of adolescent idiopathic scoliosis, and males with adolescent idiopathic scoliosis.

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Section: Measurement Of Morphologic Features Of the Pediclementioning

confidence: 99%

What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study

Gao

Chen

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…On the other hand, both their CSAs ( y = −5.665 + 0.591 × age ± 1.251, y = −11.281 + 0.853 × age ± 1.653) and volumes ( y = −9.279 + 0.849 × age ± 2.302, y = −16.117 + 1.155 × age ± 1.832) followed linearly. Ossification progression within the neural processes is relevant in the diagnosis of neural tube defects [ 5 , 20 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Morphometric study of the T6 vertebra and its three ossification centers in the human fetus

Szpinda

Woźniak

et al. 2013

Surg Radiol Anat

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PurposeKnowledge on the normative growth of the spine is critical in the prenatal detection of its abnormalities. We aimed to study the size of T6 vertebra in human fetuses with the crown-rump length of 115–265 mm.Materials and methodsUsing the methods of computed tomography (Biograph mCT), digital image analysis (Osirix 3.9) and statistics, the normative growth of the T6 vertebral body and the three ossification centers of T6 vertebra in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17–30 weeks were studied.ResultsNeither male–female nor right–left significant differences were found. The height, transverse, and sagittal diameters of the T6 vertebral body followed natural logarithmic functions as y = −4.972 + 2.732 × ln(age) ± 0.253 (R2 = 0.72), y = −14.862 + 6.426 × ln(age) ± 0.456 (R2 = 0.82), and y = −10.990 + 4.982 × ln(age) ± 0.278 (R2 = 0.89), respectively. Its cross-sectional area (CSA) rose proportionately as y = −19.909 + 1.664 × age ± 2.033 (R2 = 0.89), whereas its volumetric growth followed the four-degree polynomial function y = 19.158 + 0.0002 × age4 ± 7.942 (R2 = 0.93). The T6 body ossification center grew logarithmically in both transverse and sagittal diameters as y = −14.784 + 6.115 × ln(age) ± 0.458 (R2 = 0.81) and y = −12.065 + 5.019 × ln(age) ± 0.315 (R2 = 0.87), and proportionately in both CSA and volume like y = −15.591 + 1.200 × age ± 1.470 (R2 = 0.90) and y = −22.120 + 1.663 × age ± 1.869 (R2 = 0.91), respectively. The ossification center-to-vertebral body volume ratio was gradually decreasing with age. On the right and left, the neural ossification centers revealed the following models: y = −15.188 + 6.332 × ln(age) ± 0.629 (R2 = 0.72) and y = −15.991 + 6.600 × ln(age) ± 0.629 (R2 = 0.74) for length, y = −6.716 + 2.814 × ln(age) ± 0.362 (R2 = 0.61) and y = −7.058 + 2.976 × ln(age) ± 0.323 (R2 = 0.67) for width, y = −5.665 + 0.591 × age ± 1.251 (R2 = 0.86) and y = −11.281 + 0.853 × age ± 1.653 (R2 = 0.78) for CSA, and y = −9.279 + 0.849 × age ± 2.302 (R2 = 0.65) and y = −16.117 + 1.155 × age ± 1.832 (R2 = 0.84) for volume, respectively.ConclusionsNeither sex nor laterality differences are found in the morphometric parameters of evolving T6 vertebra and its three ossification centers. The growth dynamics of the T6 vertebral body follow logarithmically for its height, and both sagittal and transverse diameters, linearly for its CSA, and four-degree polynomially for its volume. The three ossification centers of T6 vertebra increase logarithmically in both transverse and sagittal diameters, and linearly in both CSA and volume. The age-specific reference intervals for evolving T6 vertebra present the normative values of potential relevance in the diagnosis of congenital spinal defects.

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“…Studies such as Carmouche et al, 21 cited in this review, have clearly demonstrated the correlation between increased insertional torque and increased pullout resistance in osteoporotic bone. This is likely due to the advantage it provides in achieving greater bony purchase of cortical bone, which can be highly variable between patients due to age, 48 as well as demonstrated differences between men and women. 34 In recent biomechanical studies, it has been demonstrated that the density of the bone in contact with the screw threads is strongly correlated with POS.…”

Section: Discussionmentioning

confidence: 99%

Currently Adopted Criteria for Pedicle Screw Diameter Selection

et al. 2019

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Background: Transpedicular screw insertion has become widely accepted for the correction of spinal deformity as well as degenerative and traumatic injury, but adoption of this technique has remained less widespread in the thoracic compared to the lumbar spine. This is thought to be associated with the relative technical difficulty of screw insertion into the narrower widths of the thoracic pedicles and the neurologic and mechanical risks associated with breach of the pedicle wall. The surgical decision making involves determining the appropriate sized screw for maximum fixation strength while simultaneously respecting the structural integrity of the vertebral pedicles to prevent a breach and provide better fixation. This paper presents a systematic review of criteria for thoracic pedicle screw diameter (SD) selection in order to orient inexperienced surgeons on the impact of this selection on pedicle breaching and fixation strength. Methods: We performed a systematic literature review focused on studies reporting SD selection in relation to pedicle dimensions, measures of fixation strength, and breach rate. Results: Twenty-nine articles that measured fixation strength, breach rate, and/or provided SD in relation to pedicle width were selected for inclusion. Conclusions: A commonly accepted criteria for pedicle SD selection has not yet been proposed. Screw diameters approximately 80% of the pedicle width have been adopted, but this proportion is rarely reported in the midthoracic vertebrae for which smaller pedicles and inadequate hardware specificity result in higher breach rates. Depending upon the insertion technique adopted, greater specificity in diameter selection by vertebral level should be pursued in order to maximally target cortical bone purchase. Clinical Relevance: Based on this review of the literature, we believe that proper selection of the SD for individual vertebral level directly affects the insertion technique and the potential breach.

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Evaluation of thoracic pedicle morphometry in a Chinese population using 3D reformatted CT

Cited by 15 publications

References 37 publications

What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study

What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study

Morphometric study of the T6 vertebra and its three ossification centers in the human fetus

Currently Adopted Criteria for Pedicle Screw Diameter Selection

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