Pedicle Morphology of the Lower Thoracic, Lumbar, and S1 Vertebrae: An Indian Perspective

Chadha, Manish; Balain, Birender; Maini, Lalit; Dhaon, BK

doi:10.1097/01.brs.0000058929.92839.1a

Cited by 46 publications

(55 citation statements)

References 22 publications

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“…Since CT scanning can measure inner cortical parameters, which are reported to be well correlated with those of direct cadaveric measurements [3,4], the preoperative evaluation of lumbar pedicles using CT is currently recommended for selecting the length and diameter of the pedicle screw. Regarding the selection of the pedicle screw diameter, the measurements of the TPW on the axial plane of CT scans are recommended [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative evaluation of the pedicle morphology and appropriate screw size selection based on computed tomography (CT) images are essential for the accurate insertion of pedicle screws. The actual measurement values of the transverse pedicle width (TPW) on the axial plane of the CT image are recommended as an index to determine the appropriate pedicle screw diameter [1][2][3][4]. However, the shape of the coronal section of lumbar pedicles is not round, but oval, especially at the lower lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of lumbar pedicle morphology in degenerative spines using multiplanar reconstruction computed tomography: what can be the reliable index for optimal pedicle screw diameter?

et al. 2012

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Purpose The measurement of transverse pedicle width is still recommended for selecting a screw diameter despite being weakly correlated with the minimum pedicle diameter, except in the upper lumbar spine. The purpose of this study was to reveal the difference between the minimum pedicle diameter and conventional transverse or sagittal pedicle width in degenerative lumbar spines. Methods A total of 50 patients with degenerative lumbar disorders without spondylolysis or lumbar scoliosis of [10°who preoperatively underwent helical CT scans were included. The DICOM data of the scans were reconstructed by imaging software, and the transverse pedicle width (TPW), sagittal pedicle width (SPW), minimum pedicle diameter (MPD), and the cephalocaudal inclination of the pedicles were measured. Results The mean TPW/SPW/MPD values were 5.46/ 11.89/5.09 mm at L1, 5.76/10.44/5.39 mm at L2, 7.25/ 10.23/6.52 mm at L3, 9.01/9.36/6.83 mm at L4, and 12.86/ 8.95/7.36 mm at L5. There were significant differences between the TPW and MPD at L3, L4, and L5 (p \ 0.01) and between the SPW and MPD at all levels (p \ 0.01). ConclusionsThe MPD was significantly smaller than the TPW and SPW at L3, L4, and L5. The actual measurements of the TPW were not appropriate for use as a direct index for the optimal pedicle screw diameter at these levels. Surgeons should be careful in determining pedicle screw diameter based on plain CT scans especially in the lower lumbar spine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of lumbar pedicle morphology in degenerative spines using multiplanar reconstruction computed tomography: what can be the reliable index for optimal pedicle screw diameter?

et al. 2012

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“…(2) root exit angle (REA): the angle between the midline and the axis of the nerve root in the frontal plane; (3) lumbar pedicle height at the isthmus (PH); and (4) lumbar pedicle width at the isthmus (PW).…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] There have been few anatomical studies of the lumbar roots and their relationship with adjacent structures. [9][10][11][12][13] There are considerable variations in the collected data, which can be mainly attributed to individual variations, different degrees of degenerative change in the spine, and variations in the techniques and materials used in the studies.…”

Section: Introductionmentioning

confidence: 99%

The lumbar roots and pedicles: a morphometric analysis and anatomical features

Torun

Tuna

Büyükmumcu

et al. 2008

Journal of Clinical Neuroscience

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“…Transpedicular screw fixation methods are increasingly being used worldwide and because transpedicular screws provide sufficient mechanical strength and pull-out strength, almost all spinal surgeons currently use transpedicular screw systems 3,8) . However, the mechanical properties of these systems vary with regard to individual pedicular anatomy, especially in pedicle width, length, angle, and chord length 1) .…”

Section: Introductionmentioning

confidence: 99%

Pedicular and Extrapedicular Morphometric Analysis in the Korean Population : Computed Tomographic Assessment Relevance to Pedicle and Extrapedicle Screw Fixation in the Thoracic Spine

Kim

Choi

Chang

et al. 2009

J Korean Neurosurg Soc

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Objective : To evaluate the anatomical parameters that must be considered when performing thoracic transpedicular or extrapedicular screw fixation. Methods : We selected 958 vertebrae (1,916 pedicles) from 98 patients for analysis. Eight parameters were measured from CT scans : the transverse outer pedicular diameter, transverse inner pedicular diameter, length, angle, chord length of the pedicles and the transverse width, angle, and chord length of the pedicle-rib units. Results : The age of the patients ranged from 21 to 82 years (mean : 48.2 years) and there were 57 men and 41 women. The narrowest transverse outer pedicular diameter was at T5 (4.4 mm). The narrowest pedicle length was at T1 (15.9 mm). For pedicle angle, T1 was 31.6 degrees, which was the most convergent angle, and it showed the tendency of the lower the level, the lesser the convergent angle. The chord length showed a horizontal pattern with similar values at all levels. For the PRU width, T5 showed a similar pattern to the pedicle width at 13.4 mm. For the PRU angle, T1 was the largest angle at 46.2 degrees and the tendency was the lower the level, the narrower the angle. For chord length, T1 was the shortest at 46.9 mm and T8 was the longest at 60.1 mm. Conclusion : When transpedicular screw fixations carried out at the mid-thoracic level, special care must be taken because there is a high chance of danger of medial wall violation. In these circumstances, extrapedicular screw fixation may be considered as an alternative treatment.

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Pedicle Morphology of the Lower Thoracic, Lumbar, and S1 Vertebrae: An Indian Perspective

Cited by 46 publications

References 22 publications

Analysis of lumbar pedicle morphology in degenerative spines using multiplanar reconstruction computed tomography: what can be the reliable index for optimal pedicle screw diameter?

Analysis of lumbar pedicle morphology in degenerative spines using multiplanar reconstruction computed tomography: what can be the reliable index for optimal pedicle screw diameter?

The lumbar roots and pedicles: a morphometric analysis and anatomical features

Pedicular and Extrapedicular Morphometric Analysis in the Korean Population : Computed Tomographic Assessment Relevance to Pedicle and Extrapedicle Screw Fixation in the Thoracic Spine

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