Morphometry of the decrease thoracic and lumbar pedicles and its relevance in pedicle fixation.
Musculoskelet Surg. 2018 Feb 03;:
Authors: Mohanty SP, Pai Kanhangad M, Bhat SN, Chawla S
PURPOSE: To evaluate the pedicle morphology within the decrease thoracic and lumbar backbone in an Indian inhabitants and to find out the causes of pedicle wall violation by pedicle screws.
METHODS: Computerised tomographic scans of 135 consecutive sufferers with thoracolumbar and lumbar backbone fractures had been prospectively analysed to find out the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path size at 527 unhurt ranges had been measured. Put up-operative CT scans of 117 sufferers had been analysed to find out the accuracy of 468 pedicle screws at 234 vertebrae.
RESULTS: The bottom (imply ± SD) transverse pedicle width within the decrease thoracic backbone was 5.four ± zero.70 mm, whereas within the lumbar backbone it was 7.2 ± zero.87 mm. The shortest (imply ± SD) screw path size in decrease thoracic pedicles was 35.eight ± 2.10 and 41.9 ± 2.18 mm within the lumbar backbone. The imply transverse pedicle angle within the decrease thoracic backbone was persistently lower than 5°, whereas it steadily elevated from L1 by means of L5 from eight.5° to 30°. Forty-one screws violated the pedicle wall, attributable to misguided angle of screw insertion.
CONCLUSIONS: Within the present research, pedicle dimensions had been smaller in comparison with the Western inhabitants. In Indian sufferers, pedicle screws of 5 mm diameter and 30 mm size, and 6 mm diameter and 35 mm size can safely be used within the decrease thoracic and lumbar backbone, respectively. Nevertheless, it is very important assess the pedicle morphology on imaging previous to pedicle fixation.
PMID: 29397548 [PubMed – as supplied by publisher]