Pc tomography-based morphometric evaluation of the cervical backbone pedicles C3-C7.
Acta Neurochir (Wien). 2018 Feb 06;:
Authors: Westermann L, Spemes C, Eysel P, Simons M, Scheyerer MJ, Siewe J, Baschera D
BACKGROUND: Our purpose was to look at the particular dimensions of cervical pedicles in a big Caucasian cohort on excessive dissolving CT scans.
METHODS: A retrospective evaluation of 100 cervical backbone CT scans with a most slice thickness of 1 mm in axial, sagittal, and coronal reconstructions was carried out. The pedicle axial size (PAL), interior and outer pedicle diameter (IPD/OPD), pedicle sagittal and transverse angle (PSA/PTA), pedicle peak (PH), pedicle width (PW), and the cortical thickness (COT) at completely different margins have been measured by two impartial observers. A complete of 1000 cervical pedicles (C3-C7) of 52 male (age 58?±?17.47 years, peak 177.97?±?eight.17 cm) and 48 feminine sufferers (age 57?±?19.07 years, peak 165.50?±?7.44) have been measured.
RESULTS: Cortical thickness on the medial limitation of the pedicle was 1.77?±?Zero.43 and Zero.90?±?Zero.36 mm on the lateral limitation (p?<?Zero.001). The imply PAL ranged from 30.5 mm at C4 degree to 35.three mm at C6 degree. PW and PAL have been smaller within the feminine than within the male sufferers. The smallest values for PW have been at C3 with 29.17% of males and 52.88% of females <?four.5 mm. The proportion of sufferers with PW?<?four.5 mm decreased caudally with lower than 10% of pedicles beneath C4 in male contributors and beneath C6 in feminine contributors. Imply PTA ranged from 34.6° to 48.02° peaking at C4 and C5 ranges. No gender-specific distinction was discovered for PTA and PSA (p???Zero.13). IPD and OPD have been bigger in males (p?<?Zero.001), and physique peak correlated considerably with IPW (p???Zero.Zero19) and OPW (p???Zero.003). The interrater reliability was superb for PW, PH, and IPD (Zero.84-Zero.86), good for OPD, PTA, and PSA (Zero.64-Zero.79), and reasonable for PAL (Zero.54) and cortical thickness (Zero.44).
CONCLUSIONS: Peculiarities of pedicle dimension of this central European cohort are akin to morphometric research in different ethnicities. Preoperative planning earlier than cervical pedicle screw insertion on fine-cut CT scans demonstrates good interrater reliability for all essential dimensions and angulations. Greater than half of feminine sufferers and nearly a 3rd of male sufferers had a PW of lower than four.5 mm at C3 degree. Despite the fact that this share decreases caudally, pedicle screws won’t be secure to insert in a noteworthy share of sufferers.
PMID: 29411117 [PubMed – as supplied by publisher]