Laptop 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), inside and outer pedicle diameter (IPD/OPD), pedicle sagittal and transverse angle (PSA/PTA), pedicle top (PH), pedicle width (PW), and the cortical thickness (COT) at completely different margins have been measured by two unbiased observers. A complete of 1000 cervical pedicles (C3-C7) of 52 male (age 58?±?17.47 years, top 177.97?±?eight.17 cm) and 48 feminine sufferers (age 57?±?19.07 years, top 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 stage to 35.three mm at C6 stage. 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 share of sufferers with PW?<?four.5 mm decreased caudally with lower than 10% of pedicles under C4 in male individuals and under C6 in feminine individuals. 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 top 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 corresponding 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 necessary 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 stage. Despite the fact that this proportion decreases caudally, pedicle screws won’t be protected to insert in a noteworthy proportion of sufferers.
PMID: 29411117 [PubMed – as supplied by publisher]