Computed tomographic-based morphometric study of thoracic spine and its relevance to anaesthetic and spinal surgical procedures

Abstract

A thorough knowledge of anatomical and radiological characteristics of the spine and their variations is essential for the clinicians. Data collected in the present study provides baseline normative values in Indian population and will help in guiding safe and effective completion of both surgical and anaesthetic procedures in the thoracic spine. Computer software aided morphometric data can help in selecting appropriate size and optimal placement of the implant with minimal procedural difficulties and complications during spine surgery.

Thoracic Pedicle Morphometry of Dry Vertebral Columns in Relation to Trans-Pedicular Fixation: A Cross-Sectional Study From Central India

“…In the present study, transverse pedicle angles from T1 to T10 vertebrae were found to be more compared to studies performed on Caucasians. Our findings of the pedicles being angulated medially, postero-anteriorly, decreasing in the cephalo-caudad direction from T1 to T4, increasing slightly at T5, and then decreasing trend from T5 to T12, are similar to other studies from India [10,16,17]. The Caucasian studies show a gradually decreasing trend from T1 to T12 [19].…”

“…Our findings are in concurrence with other authors in that the risk of a cortical breach during pedicle screw insertion is highest from T3 to T8 levels using conventional techniques [17,[21][22][23]. Various modifications like the 'in-out-in' technique, medial margin targeting method, pedicle or transverse process hooks, extra-pedicular screw, cannulated screw, laminar screw, and the cortical bone trajectory method have been studied as safe alternatives for thoracic spine fixation [20,[24][25][26][27][28][29].…”

“…The pedicle width gradually decreased from T1 to T5 and then, started increasing from T6 toT12 in the present study. Similar trend was also reported in other studies [6,8,10,13,16,17]. This pattern of change in the size of the pedicles may be due to transition from a more mobile cervicothoracic junction to a relatively fixed mid-thoracic region, and again, to a mobile thoracolumbar junction putting differential stress on the facet joints and pedicles.…”

“…The rigidity and rotational stability of pedicular screw fixation systems are determined by the pull-out strength and depth of insertion into the vertebral body; the screw diameter should fill more than 70% of the pedicle diameter, the wider the screw, the stronger is the fixation [21]. Many authors have described the morphometric aspects of the thoracic spine and the details of the pedicle sizes and dimensions by means of computed tomography (CT) scan, plain radiographs, direct specimen measurement and quantitative 3-dimensional anatomic techniques [6,[8][9][10]12,13,17,19,20].…”

Ex vivo virtual and 3D printing methods for evaluating an anatomy‐based spinal instrumentation technique for the 12th thoracic vertebra

“…This proposed method for investigating spinal instrumentation can be performed at any spinal level for experimenting on combinations of screw size, angulation, entry point validation, and so on. This can provide a useful means of teaching instrumentation techniques and considerations that cannot be demonstrated using two‐dimensional material alone (Kaur, Singh, Prasath, Magu, & Tanwar, ). Another advantage is the compatibility of necessary software tools with normal operating hardware.…”