Computerized Tomography–Based Morphometric Analysis of Subaxial Cervical Spine Pedicle in Asymptomatic Indian Population

Farooque, Kamran; Yadav, Rahul; Chowdhury, Buddhadev; Gamanagatti, Shivanand; Kumar, Atin; Meena, Pradeep

doi:10.14444/5017

Cited by 5 publications

(7 citation statements)

References 29 publications

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“…We also found that PW progressively increased for both males and females from C3 to C7, a finding also echoed to prior Indian studies. [ 3 , 6 ] In our study, the mean PH of males was greater than females at all levels from C2 to C7 which is similar to previous reports [ Tables 8 and 9 ]. [ 2 , 4 , 5 , 8 , 9 ] Further, we also noted that in Indian adult females, 23.07% at C3 and 15.38% at C4 had mean PW <4 mm.…”

Section: Discussionsupporting

confidence: 92%

Computed tomographic analysis of cervical spine pedicles in the adult Indian population

Kumar

Saini

Singh

et al. 2021

Surgical Neurology International

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Background: Cervical pedicle screw insertion is a technically demanding procedure that carries the risk of catastrophic damage to surrounding neurovascular structures. Here, we analyzed computed tomography (CT)-based three-dimensional cervical spine pedicle geometry to determine the level and sex-specific morphologic differences in the adult Indian population. Methods: The CT scans of 200 patients (2400 pedicles) without significant cervical spine pathology were collected. The mean pedicle width (PW), pedicle height (PH), pedicle axial length (PAL), and pedicle transverse angle (PTA) from C2 to C7 were measured. Results: The smallest mean PW was at C3 in both males (4.85 ± 0.73 mm) and females (4.31 ± 0.43 mm); 7.08% of all pedicles were found to have mean PW of <4 mm. The smallest mean PH was at C5 in both males (6.25 ± 0.67mm) and females (5.54 ± 0.52 mm). The smallest mean PAL was at C2 in both males (27.46 ± 1.69mm) and females (25.90 ± 1.88 mm). The mean PW, PH, and PAL were significantly greater in males than females at all levels (P < 0.05). The smallest mean PTA was at C3 in males (41.79 ± 2.53°) and at C7 in females (42.40 ± 2.27°). Conclusion: In the adult Indian population, the PW, PH and PAL were smaller than in the typical western population. Females had even smaller PW, PH and PAL as compared to males. We recommend that a small inventory of 3.5mm screws between 20mm to 30mm length be used in most cases where cervical pedicle screws are being used in the Indian population. However, individual vertebrae should be screened preoperatively with CT scans to exclude gross anatomical variations, especially in females and at the C3 and C4 levels.

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Section: Discussionsupporting

confidence: 92%

Computed tomographic analysis of cervical spine pedicles in the adult Indian population

Kumar

Saini

Singh

et al. 2021

Surgical Neurology International

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“…Several other reports came about afterwards that showed that sex-and ethnic-based variations existed. 6,8,9,[13][14][15][16][17][18][19][20][21] Chazono, 22 an author of one of the aforementioned reports, reviewed some of these publications and found that the reported ethnic differences were within 10%-15% of each other.…”

Section: Discussionmentioning

confidence: 99%

“…The measurements presented in this study are similar to other Asian countries. 8,9,16,19,[23][24][25] Taking into account the thickness of the cortex, 0.5 mm for most levels, cannulation and instrumentation of C5, C6, and C7 with a 3.5-mm screw is certainly feasible in our population, but more so in males than in females. The transverse angle decreasing as we go into the lower levels also helps the starting point be within reach within the operative field.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Ethnic variability in cervical pedicle anatomy was established by several previous reports. [6][7][8][9] Cervical pedicle screw instrumentation is rarely used in our region, with reluctance usually attributed to the small size of cervical pedicles in our population. Given the scarcity of published data accurately representing our target population, it is difficult to support this argument.…”

Section: Introductionmentioning

confidence: 99%

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Morphometric Analysis of Subaxial Cervical Spine Pedicles in a Middle Eastern Population

et al. 2021

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Background: Pedicle screw instrumentation of the posterior cervical spine is the most secure form of fixation available to surgeons. It has not achieved widespread use yet in the Middle East, mostly due to concerns regarding its feasibility in the target population. A detailed morphometric analysis of the lower cervical spine pedicles using computerized tomography (CT) was proposed to address this issue.Methods: Two hundred and seventy patients were enrolled in the study. CT scans were reviewed by two experienced assessors, and measurements of pedicle width (PW), height (PH), and transverse angle (TA) were recorded for all patients. Interobserver and intraobserver reliability were calculated using the kappa statistic. Sex differences were also recorded and analyzed. The t test was used to assess for any significant differences in measurements due to sex (P , .05).Results: The mean PW varied from 4.4 mm in C3 to 6.1 mm in C7. The mean PH was 6.4 mm in C3 and 6.8 mm in C7. Pedicle TA varied from 42 to 51 degrees between the different levels. Sex differences were observed and were statistically significant for PW and PH. Interobserver reliability was high for PW and PH, but was low for TA. Intraobserver reliability was 0.99 for both assessors.Conclusion: This study provides reliable PW and PH measurements and demonstrates that cervical pedicle screw instrumentation is feasible in our local population. Significant variability exists, however, and each patient must be addressed individually for best results.Level of Evidence: 3.Clinical Relevance: This study shows that the morphology of the subaxial cervical pedicle permits instrumentation in a majority of cases of our target population.

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“…The Deep neck flexors are small stabilizing muscles located on the anterior and anteriorlateral surfaces of the cervical spine and are deep to the sternocleidomastoid muscle. The deep neck flexor muscles are identified as the Longus capitis and Longus colli muscles 6,7 . The location of deep neck flexor muscles suggest they play an important role in stabilizing the cervical spine.…”

Section: Classification Of Smartphone Addiction Disordermentioning

confidence: 99%

To Study the Effects of Deep Neck Flexor Strengthening Exercises and Mckenzie Neck Exercises on Smart Phone Users Suffering From Neck Pain: A Comparative Study

Yana

Koch

Kalita

et al. 2022

Int J Life Sci Pharm Res

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Smartphone has become an integral part of our lives, they generally have a small screen because of which it is more likely to induce a slouched posture creating a line of sight mostly below eye level, formulating an improper posture when used for a prolonged period of time, for example, forward head posture (FHP) leading to neck pain. The purpose of the study is to compare the effectiveness of Deep neck flexor strengthening exercises with that of McKenzie neck extension exercises on smartphone users suffering from neck pain. It is a comparative experimental study. This study included (N=40) subjects with neck pain within the age group of 25-45 years. They arerandomly assigned into 2 groups (Group A and B). Group A had 20 (N=20) subjects who are treated with Deep neck flexor strengthening exercises, Group B had 20 (N=20) who are treated with McKenzie neck extension exercises. The subjects were given intervention 5 days a week for 6 weeks. For within-group analysis Paired sample t-test was used and to analyze between-group variables Independent sample t-test was done. Between DNF and McK groups no significant difference was found in NDI(p<1.18 ) and SFMPQ(p <1.17) while all outcome measures showed a significant difference in both DNF and McK groups(p=0.00)within the groups The results indicated that although both the treatment techniques, DNF and McK are effective in alleviating the neck pain in Smartphone users in terms of decreasing pain intensity and increasing functional ability as there was a significant difference within the two groups, but there was no significant difference between the DNF and McK group in decreasing pain intensity, increasing functional ability

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Computerized Tomography–Based Morphometric Analysis of Subaxial Cervical Spine Pedicle in Asymptomatic Indian Population

Cited by 5 publications

References 29 publications

Computed tomographic analysis of cervical spine pedicles in the adult Indian population

Computed tomographic analysis of cervical spine pedicles in the adult Indian population

Morphometric Analysis of Subaxial Cervical Spine Pedicles in a Middle Eastern Population

To Study the Effects of Deep Neck Flexor Strengthening Exercises and Mckenzie Neck Exercises on Smart Phone Users Suffering From Neck Pain: A Comparative Study

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