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

Torun, Fuat; Tuna, Hakan; Büyükmumcu, Mustafa; Çağlar, Şükrü; Baysefer, Alper

doi:10.1016/j.jocn.2007.08.006

Cited by 19 publications

(7 citation statements)

References 20 publications

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“…Females also have slightly smaller pedicles [5]. Torun et al found the widest lumbar pedicle was measured at L5 as 17.1±4.2 mm and the narrowest at L1 as 8.4±1.8 mm (5). That is why we would reserve transpedicular access only for L3-5 in males and L4 and L5 in females.…”

Section: Discussionmentioning

confidence: 92%

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Transpedicular endoscopic surgery for lumbar spinal synovial cyst—report of two cases

Krzok¹,

Telfeian²,

Wagner³

et al. 2016

J. Spine Surg.

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Background: Lumbar facet cysts are a benign, degenerative, and fairly uncommon cause for lumbar radiculopathy. The standard surgical treatment for lumbar facet cysts often requires a laminectomy and medial facetectomy which can further destabilize a pathological motion segment. The authors present here a novel technique for transpedicular endoscopic access to the pathology that obviates the need to violate the lamina or facet.Methods: Two patient cases are described where the lumbar 4-5 facet cysts arise medial to the pedicle.Percutaneous access to the cysts was established by drilling through the adjacent pedicle creating a 7-mm corridor to establish access for the endoscopic tubular retractor and the working channel endoscope. Straight and bendable forceps were used to remove the cysts under direct visualization.Results: Following surgery, the patients' symptoms showed immediate regression with complete relief of one patient's foot drop by 6 months.Conclusions: Transpedicular endoscopic access is described as novel minimally invasive surgical option in the awake patient for lumbar facet cysts adjacent to the Lumbar 4 or 5 pedicle.

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Section: Discussionmentioning

confidence: 92%

“…Cadaver and radiologic examinations reveal that the lumbar pedicle is longer and narrower at L1 and becomes gradually shorter and wider down the lumbar spine to L5 (5). Females also have slightly smaller pedicles [5]. Torun et al found the widest lumbar pedicle was measured at L5 as 17.1±4.2 mm and the narrowest at L1 as 8.4±1.8 mm (5).…”

Section: Discussionmentioning

confidence: 98%

Transpedicular endoscopic surgery for lumbar spinal synovial cyst—report of two cases

Krzok¹,

Telfeian²,

Wagner³

et al. 2016

J. Spine Surg.

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“…EA and SEA include Japan and Singapore, WA includes Turkey and Israel, SA includes India and Pakistan, and OA includes New Zealand and Australia. Of the 24 articles containing pedicle, 5 were from the US [ 7 – 11 ], 7 from CN [ 12 – 18 ], 4 from EA and SEA (2 from Japan [ 19 , 20 ] and 2 from Singapore [ 21 , 22 ]), 3 from WA (2 from Turkey [ 23 , 24 ] and 1 from Israel [ 25 ]), 3 from SA (2 from India [ 26 , 27 ] and 1 from Pakistan [ 28 ]), and 2 from OA (1 from New Zealand [ 29 ] and 1 from Australia [ 30 ]), detailed data are presented in Table 1 . Of the 18 articles containing pedicle height, 3 were from the US [ 7 , 8 , 10 ], 5 from CN [ 12 , 14 , 16 – 18 ], 4 from EA and SEA (2 from Japan [ 19 , 20 ] and 2 from Singapore [ 21 , 22 ]), 3 from WA (2 from Turkey [ 23 , 24 ] and 1 from Israel [ 25 ]), 1 from SA (1 from Pakistan [ 28 ]), and 2 from OA ((1 from New Zealand [ 29 ] and 1 from Australia [ 30 ]), and detailed data are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 18 articles containing pedicle height, 3 were from the US [ 7 , 8 , 10 ], 5 from CN [ 12 , 14 , 16 – 18 ], 4 from EA and SEA (2 from Japan [ 19 , 20 ] and 2 from Singapore [ 21 , 22 ]), 3 from WA (2 from Turkey [ 23 , 24 ] and 1 from Israel [ 25 ]), 1 from SA (1 from Pakistan [ 28 ]), and 2 from OA ((1 from New Zealand [ 29 ] and 1 from Australia [ 30 ]), and detailed data are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Morphometric measurement of lumbar pedicle in different regions: a systematic review

et al. 2023

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Objective To collect the data of pedicle width and height in different areas, and to investigate the difference and variation rule of pedicle width and height. Methods Comprehensive search of PubMed, Ovid Medline, and Web of science databases was performed. Collected data were imported into SPSS, and one-way ANOVA test and post hoc test were used to determine whether there were statistical differences in pedicle width and height between the different regions. Results Oceania had the largest pedicle width and height, followed by Americans. West Asian had the largest pedicle width in Asia, followed by East and Southeast Asian, and Chinese and South Asian had similar pedicle width. Different from the variation pattern of pedicle width, the pedicle height of Chinese, East and Southeast Asian and West Asian in Asian range is similar, but the pedicle height of South Asian is significantly smaller than the first three, and has statistical significance. Conclusions People in different regions have similar patterns of variation in pedicle width and height even though they belong to different ethnic groups. This phenomenon is particularly prominent and pronounced in populations in geographically close areas, which may be related to inter-ethnic integration due to population movement between adjacent areas. There is a relationship between the morphological characteristics of the human lumbar pedicle and geographical location.

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“…Research was performed on cadavers with no clinical correlation [9] [5] or focusing on dynamic changes with no inclusion of a control group for comparison [10,11]. To our knowledge, there is no study considering the relationship between PH and VH.…”

Section: Discussionmentioning

confidence: 99%

Influence of anatomical variations on lumbar foraminal stenosis pathogenesis

et al. 2014

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Introduction Symptomatic foraminal stenosis has been observed in patients with degenerative disc disease, scoliosis, asymmetrical disc degeneration and spondylolisthesis. Nevertheless not all patients with the above pathologies will develop symptomatic foraminal stenosis. We hypothesised that symptomatic patients have anatomical predisposition to foraminal stenosis, namely a larger pedicle height (PH) to vertebral body height (VH) ratio, leaving less room below the pedicle for the exiting nerve root compared to asymptomatic patients. Patient sample 66 Patients were divided in two groups. The surgical group consisted of 37 patients (average age of 61 years) who presented with severe radicular symptoms resisting to conservative measures and requiring decompression and transforaminal lumbar interbody fusion (TLIF). The control group consisted of 29 patients (average age of 51 years) presenting with low back pain (LBP) but with no radicular symptoms and who were treated conservatively. Methods We measured VH at the level of the posterior wall as well as PH on parasagittal images (CT or MRI) on all lumbar levels (L1 to L5). Statistical analysis was performed using Student's t test. ResultsNo difference in PH was found between the two groups for L1 to L4 levels. By contrast, there was a highly statistically significant difference in VH between the two groups from L1 to L4 level. In the surgical group, the VH was smaller (p \ 0.001). Conclusions Symptomatic patients with foraminal stenosis have smaller VH leading to lesser space beneath the pedicle and putting the exiting nerve root at risk in cases of spondylolisthesis or disc degeneration.

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

Cited by 19 publications

References 20 publications

Transpedicular endoscopic surgery for lumbar spinal synovial cyst—report of two cases

Transpedicular endoscopic surgery for lumbar spinal synovial cyst—report of two cases

Morphometric measurement of lumbar pedicle in different regions: a systematic review

Influence of anatomical variations on lumbar foraminal stenosis pathogenesis

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