Thoracic Pedicle: Surgical Anatomic Evaluation and Relations

Ugur, Hasan Çağlar; Attar, Ayhan; Uz, Aysun; Tekdemi̇r, İbrahi̇m; Egemen, Nihat; Genç, Yasemin

doi:10.1097/00002517-200102000-00007

Cited by 95 publications

(69 citation statements)

References 12 publications

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“…There is some controversy about the acceptability of medially misplaced pedicle screws in the thoracic spine. Anatomical studies have shown that the distance between thoracic pedicles and the dural sac is non-existent or minimal in normal human cadavers [6,21]. However, Reynolds et al [18] have demonstrated evidence of a 2-mm lateral epidural space from T7 to L4 by contrast injection into the epidural space.…”

Section: Discussionmentioning

confidence: 99%

“…4). This is how the TDG decreased the incidence and extent of medial perforations in particular, which are the most feared event because of the risk of spinal cord injury [6,12,16,19,21,22]. Only two of 66 screws (3.0%) perforated the medial wall, and in both cases the perforations were by less than 1 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Potential applications of thoracic pedicle screw instrumentation include fracture, segmental instability, hyperkyphosis, scoliosis, infection and tumor [2,3,4,10,12,20]. However, insertion of pedicle screws in the thoracic spine is technically difficult and may lead to major complications [6,12,16,19,21,22].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of a transpedicular drill guide for pedicle screw placement in the thoracic spine

Mac-Thiong

Rooze²,

Feipel³

et al. 2003

European Spine Journal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of a transpedicular drill guide for pedicle screw placement in the thoracic spine

Mac-Thiong

Rooze²,

Feipel³

et al. 2003

European Spine Journal

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“…These measurements were further verified using ImageJ software. studies examine only morphologic features of the pedicle [4,8,17,23,28,30,38,39]. None of these studies describe the morphologic features of the thoracic spine in the American population, although normal values of thoracic vertebral canal anatomy are pertinent to diagnose thoracic stenosis.…”

Section: Discussionmentioning

confidence: 99%

Establishment of Parameters for Congenital Thoracic Stenosis: A Study of 700 Postmortem Specimens

Bajwa

Toy

Ahn

2012

Clinical Orthopaedics &Amp; Related Research

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Background Congenital thoracic stenosis (CTS) occurs when the bony anatomy of the canal is smaller than expected in the general population. The diagnosis currently is made based on the clinical impression from subjective radiographic studies, and the normal values for CTS have not been established. Questions/purposes We provided a statistical definition for CTS based on objective measurements of thoracic spine specimens and explored parameters that might predict CTS. Methods We selected 700 adult skeletal specimens from the Hamann-Todd Collection in the Cleveland Museum of Natural History (Cleveland, OH, USA). We used calipers to measure the sagittal canal diameter (SCD), interpedicle distance (IPD), and pedicle length (PL). At each level, canal area was calculated using a geometric formula, a standard distribution was created, and values two SDs below the mean were considered congenitally stenotic. . A SCD less than 15 mm and an IPD less than 18.5 mm were predictive of CTS at each level with sensitivities and specificities of 80% to 100%. Conclusions We statistically defined CTS at each level. A SCD less than 15 mm or IPD less than 18.5 mm predicted the presence of CTS at all levels. Clinical Relevance In a symptomatic patient, on routine radiologic examination, a physician should suspect stenosis of the thoracic canal if the SCD and IPD are less than 15 and 18.5 mm respectively. As a spinal deformity surgeon, the canal area is especially relevant when considering a possible canal intrusion by implants.

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“…Contrary to placement of lumbar pedicle screws, the safe placement of thoracic pedicle screws is technically challenging due to the particularities of their broad anatomic variability with progressively varying anteromedial and cephalic angulation [10,13]. This is especially relevant at the upper T2-T6 levels, which renders the insertion of pedicle screws a highly demanding technique [14,15].…”

Section: Discussionmentioning

confidence: 99%

Recording triggered EMG thresholds from axillary chest wall electrodes: a new refined technique for accurate upper thoracic (T2–T6) pedicle screw placement

et al. 2011

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Thoracic Pedicle: Surgical Anatomic Evaluation and Relations

Cited by 95 publications

References 12 publications

Evaluation of a transpedicular drill guide for pedicle screw placement in the thoracic spine

Evaluation of a transpedicular drill guide for pedicle screw placement in the thoracic spine

Establishment of Parameters for Congenital Thoracic Stenosis: A Study of 700 Postmortem Specimens

Recording triggered EMG thresholds from axillary chest wall electrodes: a new refined technique for accurate upper thoracic (T2–T6) pedicle screw placement

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