A comparison of lumbar transverse pedicle angles between ethnic groups: a retrospective review

Abstract

BackgroundSpinal surgery requires an intimate understanding of pedicle morphology to provide safe and effective outcomes. Although current research has attempted to identify morphological vertebral pedicle trends, no study has utilized computed tomography (CT) scans to compare the lumbar transverse pedicle angle (TPA) with patient demographics factors in a diverse population throughout multiple hospital centers.MethodsAnalysis of randomly selected CT scans from L1-L5 of 97 individuals who underwent imaging over a two-week period for non-back pain related complaints was conducted. Measuring 970 TPAs in total allowed for comparison of each patients’ pedicle angle with important patient specific demographics including ethnicity, age, gender, height and weight. Statistical analysis utilized multiple comparisons of demographics at each level with post-hoc Bonferroni correction analysis to compare demographics at each level.ResultsWith relation to gender, age, height or weight, no statistically significant differences were identified for TPAs at any vertebral level. However, when stratified by ethnicity, the differences in transverse pedicle angles averages (TPA –Avg) at L2 and L3 were found to be statistically significant (p < 0.05).ConclusionWe have identified a previously unknown and significant relationship between ethnicity and TPA at lumbar vertebral levels. These findings provide critical information that may be added to the operating surgeons’ knowledge of pedicle morphology. We hope this novel information can assist in preoperative planning of pedicle screw placement and potentially help improve surgical outcomes.

A novel method to evaluate transverse pedicle angle of lower lumbar using digital radiography

“…In recent years, some initial studies about accurate medicine attract people's attention, many technology were used to improve the accuracy of pedicle screw insertion, such as computer-based navigation and robotic-assisted guidance systems [20][21][22][23][24] , pedicle screw entry point [25][26][27] , TPA of lumbar 17,18,28 , both scan-and-plan registration and CT-to-uoroscopy registration methods is similar uoroscopy time exposure 29 . Still, recent reviews demonstrate that these instrument are no better than freehand technologies, but also substantially increase the costs and operation time 12,30,31 .…”

“…According to the de nition of TPA published previously 17 , assessment method can be expressed as following: Under the standard AP view, the width of pedicle is marked as 2b, and the length of pedicle under lateral view is marked as L2, L2=a2+a3 then, the estimated formula of TPA is expressed as α≈ATAN(b/L2). Measurement diagram in lumbar model and DR were revealed in Fig.…”

Statistical shape modelling of the thoracic spine for the development of pedicle screw insertion guides

“…The meta-analysis revealed much larger variations in vertebral morphology between different populations. Variations in results have also been attributed to differences in ethnic groups (Stockton et al 2019 ) and sample sizes (Tan et al 2004 ). The population used for training may not capture these distinctions.…”

Anatomic Study of the Relationship of Height and Weight to Lumbar Pedicle Diameter

“…We previously reported statistically significant differences in lumbar PD between different races and TPA between different races. [14,15] In the present study, we examined how height and weight correlated with PD. These variables showed statistically significant positive correlation in our study, however, height explained only 10% of the variance in PD and weight explained only 3-4%.…”