Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine

Chen, Zheng; Huang, Qi-Shan; Y, Hu; Wang, Xiangyang; Chen, Wei

doi:10.1007/s00264-008-0675-z

Cited by 14 publications

(10 citation statements)

References 12 publications

(9 reference statements)

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“…These divergent findings may be due to the smaller stature of Asian patients. 8 Regarding translaminar fixation, we conclude that it is possible to safely use 3.5 mm screws only in children older than 7 years old, finding similar to that of a previous study. 5 Our results clash, however, with those presented by Kretzer et al, 23 who found no size-related limitations for introducing translaminar screws.…”

Section: Discussionsupporting

confidence: 89%

Tomographic Analysis of C7, T1 and T2 Vertebrae Anatomy in Children

et al. 2021

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Objective: To evaluate and compare anatomical measurements of C7, T1 and T2 vertebrae in children from 3 to 12 years of age to provide useful epidemiological data for determining the safe anatomical margin for transpedicular and translaminar fixation with screws in this population. Methods: This observational retrospective cross-sectional study evaluated 76 computed tomography scans obtained over 6 months, analyzing the following parameters: the angle of attack, length, thickness and diameter of the pedicle; and the angle of attack, length and thickness of the lamina. Results: The lamina length and thickness, as well as pedicle length varied in size according to age. Although the angle of attack was similar across different ages, age-dependent variation occurred in the T1 vertebra. Conclusion: Screws with a 3.5 mm diameter are safe to use in the C7 and T2 pedicles, while the T1 pedicle allows the introduction of larger screws ranging from 3.5-4.5 mm in diameter. In the lamina, 3.5 mm screws are safe for use only in children older than 7 years. However, each case should be analyzed individually, with the present study not aiming to replace the preoperative use of CT. Level of Evidence III, Retrospective comparative study.

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Section: Discussionsupporting

confidence: 89%

Tomographic Analysis of C7, T1 and T2 Vertebrae Anatomy in Children

et al. 2021

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“…According to previous study, poor bone quality and small size of pedicles are the characteristics of young patients [ 14 ]. The bone of young children is very soft and easy to break, and the inner transverse diameters of the pedicles are smaller in very young children than in older ones [ 23 , 24 ], which may increase the difficulty of implantation. Pedicles may be anomaly or missing in some congenital scoliosis cases, which may contribute to construct/implant related complications.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for construct/implant related complications following primary posterior hemivertebra resection: Study on 116 cases with more than 2 years’ follow-up in one medical center

Guo

Zhang

Wang

et al. 2016

BMC Musculoskelet Disord

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Background: Posterior hemivertebra resection has become a safe and effective procedure for congenital scoliosis due to hemivertebra. However, there are still complications following primary posterior hemivertebra resection in recent reports. No risk factors associated with construct/implant related complications were identified so far. The purpose of this study is to analyze complications following primary posterior hemivertebra resection and to investigate the possible risk factors associated with construct/implant related complications in congenital scoliosis cases due to hemivertebra. Methods: One hundred and sixteen congenital scoliosis cases with hemivertebra (male: female = 62:54), who underwent primary posterior hemivertebra resection from January 2003 to January 2012 in our medical center, were retrospectively evaluated in this study. Medical records were reviewed and long cassette standing spinal radiographs were measured before surgery, after surgery and at the final follow-up. Complications, including construct/implant related complications and non-construct/implant related ones, were recorded by chart review. Potential risk factors, including sex, age, segmental and main scoliosis and their correction rates, usage of cage (yes or not), fusion levels (bisegmental fusion or not), location of hemivertebra and contralateral bar/rib synostosis (with or without), were also collected.

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“…Because of the complicated inner structure and the particular location, the exact quantitative parameters of the thoracic pedicle, especially the outer pedicle width, cannot be definitely determined by the imaging methods currently in use, such as plain films and ordinary CT examination. Studies indicated that the pedicle parameters can be obtained accurately by using reformatted CT images (Li et al, 2004; Zheng et al, 2009; Chen et al, 2010). Therefore, the purpose of this study was to investigate the detailed three‐dimensional morphology of the pedicles from T1 to T12 using reformatted CT images.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of thoracic pedicle morphometry in a Chinese population using 3D reformatted CT

et al. 2011

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The aim of this study was to investigate the detailed three-dimensional morphology of the pedicles from T1 to T12 in 120 Chinese patients using a light-speed Vct CT (General Electric). After reformatting the original images, the following parameters were studied: outer pedicle width (OPW), outer pedicle height (OPH), pedicle chord length (PCL), pedicle cortical thickness (PCT) of the isthmus, and transverse pedicle angle (TPA). The mean outer pedicle width, outer pedicle height, and pedicle chord length were significantly smaller in females than in males at all levels (P < 0.01). The percentage of outer pedicle width ≤ 5.0 mm and ≤ 4.5 mm was high at mid-thoracic pedicles. No significant differences were found in transverse pedicle angle and pedicle cortical thickness in males and females. Pedicle cortical thickness was significantly thinner in patients over 50 years old compared with patients below 50 years old at most levels. The results showed that a screw of larger than 4.5 mm would be too large for mid-thoracic segments in Chinese population, especially for female patients. Considering the amount of variation between individuals and the complicated structure of the thoracic pedicles, the use of the transpedicular screw fixation must be individualized for each patient and based on detailed preoperative assessment. Reformatted CT assessment is essential before this procedure is performed.

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Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine

Cited by 14 publications

References 12 publications

Tomographic Analysis of C7, T1 and T2 Vertebrae Anatomy in Children

Tomographic Analysis of C7, T1 and T2 Vertebrae Anatomy in Children

Risk factors for construct/implant related complications following primary posterior hemivertebra resection: Study on 116 cases with more than 2 years’ follow-up in one medical center

Evaluation of thoracic pedicle morphometry in a Chinese population using 3D reformatted CT

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