Systematic Review of Cervical Pedicle Dimensions and Projections

Abstract

The current study has found that there is no statistical difference in measuring the cervical pedicle via radiography (CT) or directly. There are more significant differences comparing the cervical pedicles of males and females in the European/American population than exists in the Asian population (specifically in pedicle width and height). There are also significant differences at C3 and C4 cervical pedicle between the Asian and European/American population (specifically in the pedicle axis length and transverse angle).

Anterior transpedicular screw fixation of cervical spine: Is it safe? Morphological feasibility, technical properties, and accuracy of manual insertion

“…However, Sakamoto et al 32 and Chen et al 7 reported larger means ranging from 5.7 to 7.7 mm and 5.8 to 7.7 mm, respectively. These differences might be due to samples containing different ethnic groups, as previously observed by Liu et al 24 In addition to PW, the frequency of the mean PW being greater than 4 mm is an important issue when considering ATPS placement because the desired rigid fixation can be achieved when the screw size is at least 3.5 mm. The rate of neural or vascular injury also increases when the PW is less than 4 mm.…”

“…Similar results have been published in the literature. 6,7,24 However, the mean PSA is less likely to be a limiting factor than the PTA because the PH is generally larger than the PW at all levels.…”

CT Evaluations for C2 Pedicle Screw Fixation: Multiplanar Computerized Tomography Measurements in 100 Moroccan Patients

“…Both cadaveric and radiologic studies showed that the diameter of the cervical spines is adequate for screw fixation [1,6,7]. In contrast to the manual measurement data from cadaver specimens, the ability of CT to perform measurements in living subjects offers the prospect of acquiring information that is more accurate.…”

“…This accounts for the difference pedicle length reported in those studies. In previous anatomical [9][10][11] as CT evaluation [6,12] reports investigators defined the length as the distance from the posterior surface of the C-2 inferior articulating process to the anterior surface of the vertebral body (range 25.4 mm -28.8 ± 3.4 mm). Howington JU et al [1] chose to define the length as the distance from the posterior surface of the inferior articulating process to the junction of the pedicle with the vertebral body (mean 7.9 mm, range 6.4 to 9 mm).…”

“…The cervical pedicles of Asian populations are smaller in most dimensions than Europeans and Americans but similar to Moroccan subjects. And in both races, female display smaller pedicles than their male counterparts [3,6].…”