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Cervical pedicle morphometry in a Latin American population

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ABSTRACT

The goal of this study was to conduct a detailed computed tomography (CT) assessment in the Brazilian population of the screw starting point, trajectory, and dimensions of pedicle in the cervical spine.

Two hundred consecutive patients were retrospectively evaluated using cervical spine CT, with imaging reconstruction of each cervical vertebrae in the axial plane with 2 mm, and in sagittal reconstructions with 3 mm. Parameters in axial plane included the pedicle width (PW), pedicle axis length (PAL), pedicle transverse angle (PTA), and the distance from the entry point to the point between the lamina and spinous process (DEP). Measurements in the sagittal plane involved the pedicle height (PH) and the pedicle sagittal angle (PSA).

The mean PW and PH were smaller in females than in males in all cervical vertebrae, but there were no significant differences of PTA among genders. PSA ranged from 15.2° to 23.7°. Mean values of PAL and DEP had a tendency to decrease from the proximal to distal cervical vertebrae. PW was <4 mm in 7.5% of men (C3) and 25% of women (C3), and <4.5 mm in 20% (C3 male) and 66% (C3 female). The intra- and inter-observer reliability were very good for the tomographic measurement of PW, and good for PH. For PAL, the intraobserver reliability was good, but the interobserver reliability varied from moderate to good. Considering PTA and PSA, the intraobserver reliability was good, but the interobserver reliability moderate for PTA and poor or fair for PSA. DEP measurements showed poor intraobserver reliability, and poor or moderate interobserver reliability.

Our results presented similar trend of previous studies, but the frequency of patients with PW <4.5 mm in our population is higher, suggesting an increased risk during the attempting of transpedicular screw technique.

No MeSH data available.


Graph showing the mean pedicle widths in males and females.
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Figure 3: Graph showing the mean pedicle widths in males and females.

Mentions: The general PW ranged from 4.3 to 6.8 mm (Table 3). The smallest mean PW was found at C3 in both females (4.3 mm) and males (5.1 mm), while the largest mean PW was at C7 in both females (6.0 mm) and males (6.8 mm). There was a tendency toward increasing PW as 1 advances distally in the cervical spine (Fig. 3). The mean PW was smaller in females than in males at all levels, and this difference was very highly significant at all levels (P < 0.001). The percentage of individuals with PW <4 mm is 7.5% (C3 male) and 25% (C3 female) and the percentage of individuals with PW <4.5 mm is 20% (C3 male) and 66% (C3 female).


Cervical pedicle morphometry in a Latin American population
Graph showing the mean pedicle widths in males and females.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998327&req=5

Figure 3: Graph showing the mean pedicle widths in males and females.
Mentions: The general PW ranged from 4.3 to 6.8 mm (Table 3). The smallest mean PW was found at C3 in both females (4.3 mm) and males (5.1 mm), while the largest mean PW was at C7 in both females (6.0 mm) and males (6.8 mm). There was a tendency toward increasing PW as 1 advances distally in the cervical spine (Fig. 3). The mean PW was smaller in females than in males at all levels, and this difference was very highly significant at all levels (P < 0.001). The percentage of individuals with PW <4 mm is 7.5% (C3 male) and 25% (C3 female) and the percentage of individuals with PW <4.5 mm is 20% (C3 male) and 66% (C3 female).

View Article: PubMed Central - PubMed

ABSTRACT

The goal of this study was to conduct a detailed computed tomography (CT) assessment in the Brazilian population of the screw starting point, trajectory, and dimensions of pedicle in the cervical spine.

Two hundred consecutive patients were retrospectively evaluated using cervical spine CT, with imaging reconstruction of each cervical vertebrae in the axial plane with 2&#8202;mm, and in sagittal reconstructions with 3&#8202;mm. Parameters in axial plane included the pedicle width (PW), pedicle axis length (PAL), pedicle transverse angle (PTA), and the distance from the entry point to the point between the lamina and spinous process (DEP). Measurements in the sagittal plane involved the pedicle height (PH) and the pedicle sagittal angle (PSA).

The mean PW and PH were smaller in females than in males in all cervical vertebrae, but there were no significant differences of PTA among genders. PSA ranged from 15.2&deg; to 23.7&deg;. Mean values of PAL and DEP had a tendency to decrease from the proximal to distal cervical vertebrae. PW was &lt;4&#8202;mm in 7.5% of men (C3) and 25% of women (C3), and &lt;4.5&#8202;mm in 20% (C3 male) and 66% (C3 female). The intra- and inter-observer reliability were very good for the tomographic measurement of PW, and good for PH. For PAL, the intraobserver reliability was good, but the interobserver reliability varied from moderate to good. Considering PTA and PSA, the intraobserver reliability was good, but the interobserver reliability moderate for PTA and poor or fair for PSA. DEP measurements showed poor intraobserver reliability, and poor or moderate interobserver reliability.

Our results presented similar trend of previous studies, but the frequency of patients with PW &lt;4.5&#8202;mm in our population is higher, suggesting an increased risk during the attempting of transpedicular screw technique.

No MeSH data available.