Morphologic evaluation of the thoracic vertebrae for safe free-hand pedicle screw placement in adolescent idiopathic scoliosis: a CT-based anatomical study

Cui, Guanyu; Watanabe, Kota; Hosogane, Naobumi; Tsuji, Takashi; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki; Chiba, Kazuhiro; Lenke, Lawrence G.; Matsumoto, Morio

doi:10.1007/s00276-011-0849-z

Cited by 21 publications

(12 citation statements)

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“…The horizontal diameters are the most commonly studied variables in morphometric studies of the vertebral pedicle. The average values of the different horizontal diameters (outer pedicle width) are consistent with those of other populations with respect to the patterns of behavior and the general morphometric characteristics of the thoracic spine pedicle (Zindrick et al, 1987;Islam et al, 1994;McCormack et al, 1995;Vaccaro et al, 1995a,b;Islam et al, 1996;Ebraheim et al, 1997;Ugur et al, 2001;Datir and Mitra, 2004;Christodolou et al, 2005;Nojiri et al, 2005;;Catan et al, 2007;Jun-Hak et al, 2009;Yong et al, 2009;Chen et al, 2010;Acharya et al, 2011;Singh et al, 2011;Zhuang et al, 2011Zhuang et al, , 2012Cui et al, 2012).…”

Section: General and Intersegmental Observationssupporting

confidence: 78%

“…Among the advantages of transpedicular spinal fusion are the stability of the vertebral segments involved; biomechanical superiority over other spinal fusion systems; fewer postoperative complications; short length of hospital stay; and satisfactory clinical results (Kothe et al, 1996;Tan et al, 2004;Lien et al, 2007;Wang et al, 2010;Chan et al, 2011;Beck et al, 2012;Cui et al, 2012;Lu et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Age‐ and gender‐related variations in morphometric characteristics of thoracic spine pedicle

et al. 2013

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Transpedicular spinal fusion is the most commonly used fixation technique for the surgical treatment of vertebral disorders. However, the instrumentation of the thoracic spine using this technique continues to be controversial. The objective of the present study was to determine the morphometric characteristics of the thoracic pedicle and to establish how these characteristics vary with gender and age. Two hundred thoracic spines (4800 thoracic pedicles) from individuals of known gender and age were analyzed (in accordance with the order of vertebrae). The spines were divided into six groups according to age and gender. The horizontal and vertical diameters of the thoracic pedicle were determined for each piece. The mean and standard deviation of each variable were determined, and differences between age groups for each gender were evaluated using parametric correlation tests. The pedicle diameters of men and women differed significantly for most groups (P < 0.05). The horizontal diameters decreased from T1 to T5 and increased up to T12. The vertical diameter followed a cephalocaudal pattern of development from T1-T12. The pedicle diameters decreased with increasing age in women, while the opposite trend was observed in men. In men, the dimensions of the thoracic spine pedicle increase with increasing age; in women, they decrease. These differences should be taken into account when selecting the appropriate pedicle screw.

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Section: General and Intersegmental Observationssupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Age‐ and gender‐related variations in morphometric characteristics of thoracic spine pedicle

et al. 2013

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“…The detailed knowledge on neural ossification centers appears to be an immense prerequisite for both the prenatal detection and exclusion of achondrogenesis, caudal regression syndrome, diastematomyelia [17, 26, 28], and spina bifida [11, 15]. Besides, delayed ossification centers are typical of osteochondrodysplasias [9, 28] and hypophosphatasia [31]. …”

Section: Introductionmentioning

confidence: 99%

Cross-sectional study of the neural ossification centers of vertebrae C1–S5 in the human fetus

et al. 2013

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PurposeAn understanding of the normal evolution of the spine is of great relevance in the prenatal detection of spinal abnormalities. This study was carried out to estimate the length, width, cross-sectional area and volume of the neural ossification centers of vertebrae C1–S5 in the human fetus.Materials and methodsUsing the methods of CT (Biograph mCT), digital-image analysis (Osirix 3.9) and statistics (the one-way ANOVA test for paired data, the Kolmogorov–Smirnov test, Levene’s test, Student’s t test, the one-way ANOVA test for unpaired data with post hoc RIR Tukey comparisons) the size for the neural ossification centers throughout the spine in 55 spontaneously aborted human fetuses (27 males, 28 females) at ages of 17–30 weeks was studied.ResultsThe neural ossification centers were visualized in the whole pre-sacral spine, in 74.5 % for S1, in 61.8 % for S2, in 52.7 % for S3, and in 12.7 % for S4. Neither male–female nor right–left significant differences in the size of neural ossification centers were found. The neural ossification centers were the longest within the cervical spine. The maximum values referred to the axis on the right, and to C5 vertebra on the left. There was a gradual decrease in length for the neural ossification centers of T1–S4 vertebrae. The neural ossification centers were the widest within the proximal thoracic spine and narrowed bi-directionally. The growth dynamics for CSA of neural ossification centers were found to parallel that of volume. The largest CSAs and volumes of neural ossification centers were found in the C3 vertebra, and decreased in the distal direction.ConclusionsThe neural ossification centers show neither male–female nor right–left differences. The neural ossification centers are characterized by the maximum length for C2–C6 vertebrae, the maximum width for the proximal thoracic spine, and both the maximum cross-sectional area and volume for C3 vertebra. There is a sharp decrease in size of the neural ossification centers along the sacral spine. A decreasing sequence of values for neural ossification centers along the spine from cervical to sacral appears to parallel the same direction of the timing of ossification. The quantitative growth of the neural ossification centers is of potential relevance in the prenatal diagnosis and monitoring of achondrogenesis, caudal regression syndrome, diastematomyelia and spina bifida.

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“…Both CT and MRI examinations of the vertebral column are often superior to ultrasonography for evaluation of spinal anomalies [6, 8, 12, 15, 19, 21]. Detailed knowledge on the normative growth of the spine is relevant for diagnosing its abnormalities [12, 15, 23, 30, 33] and skeletal dysplasias [29].…”

Section: Introductionmentioning

confidence: 99%

New anatomical data on the growing C4 vertebra and its three ossification centers in human fetuses

Baumgart

Szpinda

2012

Surg Radiol Anat

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PurposeDetailed knowledge on the normative growth of the spine is of great relevance in the prenatal diagnosis of its abnormalities. The present study was conducted to compile age-specific reference data for vertebra C4 and its three ossification centers in human fetuses.Materials and methodsWith the use of CT (Biograph mCT), digital image analysis (Osirix 3.9) and statistical analysis (Wilcoxon signed-rank test, Kolmogorov–Smirnov test, Levene’s test, Student’s t test, one-way ANOVA, post hoc RIR Tukey test, linear and nonlinear regression analysis), the normative growth of vertebra C4 and its three ossification centers in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17–30 weeks was examined.ResultsSignificant differences in neither sex nor laterality were found. The height and transverse and sagittal diameters of the C4 vertebral body increased logarithmically as: y = −3.866 + 2.225 × ln(Age) ± 0.238 (R2 = 0.69), y = −7.077 + 3.547 × ln(Age) ± 0.356 (R2 = 0.72) and y = −3.886 + 2.272 × ln(Age) ± 0.222 (R2 = 0.73), respectively. The C4 vertebral body grew linearly in cross-sectional area as y = −7.205 + 0.812 × Age ± 1.668 (R2 = 0.76) and four-degree polynomially in volume as y = 14.108 + 0.00007 × Age4 ± 6.289 (R2 = 0.83). The transverse and sagittal diameters, cross-sectional area and volume of the ossification center of the C4 vertebral body generated the following functions: y = −8.836 + 3.708 × ln(Age) ± 0.334 (R2 = 0.76), y = −7.748 + 3.240 × ln(Age) ± 0.237 (R2 = 0.83), y = −4.690 + 0.437 × Age ± 1.172 (R2 = 0.63) and y = −5.917 + 0.582 × Age ± 1.157 (R2 = 0.77), respectively. The ossification center-to-vertebral body volume ratio gradually declined with age. On the right and left, the neural ossification centers showed the following growth: y = −19.601 + 8.018 × ln(Age) ± 0.369 (R2 = 0.92) and y = −15.804 + 6.912 × ln(Age) ± 0.471 (R2 = 0.85) for length, y = −5.806 + 2.587 × ln(Age) ± 0.146 (R2 = 0.88) and y = −5.621 + 2.519 × ln(Age) ± 0.146 (R2 = 0.88) for width, y = −9.188 + 0.856 × Age ± 2.174 (R2 = 0.67) and y = −7.570 + 0.768 × Age ± 2.200 (R2 = 0.60) for cross-sectional area, and y = −13.802 + 1.222 × Age ± 1.872 (R2 = 0.84) and y = −11.038 + 1.061 × Age ± 1.964 (R2 = 0.80) for volume, respectively.ConclusionsThe morphometric parameters of vertebra C4 and its three ossification centers show no sex differences. The C4 vertebral body increases logarithmically in height and both sagittal and transverse diameters, linearly in cross-sectional area, and four-degree polynomially in volume. The three ossification centers of vertebra C4 grow logarithmically in both transverse and sagittal diameters, and linearly in both cross-sectional area and volume. The age-specific reference intervals for evolving vertebra C4 may be useful in the prenatal diagnosis of congenital spinal defects.

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Morphologic evaluation of the thoracic vertebrae for safe free-hand pedicle screw placement in adolescent idiopathic scoliosis: a CT-based anatomical study

Cited by 21 publications

References 54 publications

Age‐ and gender‐related variations in morphometric characteristics of thoracic spine pedicle

Age‐ and gender‐related variations in morphometric characteristics of thoracic spine pedicle

Cross-sectional study of the neural ossification centers of vertebrae C1–S5 in the human fetus

New anatomical data on the growing C4 vertebra and its three ossification centers in human fetuses

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