Morphometric Evaluation of Subaxial Cervical Vertebrae for Surgical Application of Transpedicular Screw Fixation

Bözbüga, Mustafa; Öztürk, Adnan; Ari, Zafer; Sahinoglu, Kayihan; Bayraktar, Bülent; Çeçen, Ayçiçek

doi:10.1097/01.brs.0000137065.62516.01

Cited by 50 publications

(44 citation statements)

References 16 publications

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“…One study has also shown that an individual pedicle is unlikely to be uniform in shape along its axis [33], which also impacts on the safety of pedicle screw placement. Cervical pedicles are generally oval in shape, with the height being larger than the width [6,14,27,35]. The lateral cortex is also thinner than the other cortices [14,28,33], making it the most likely to be perforated [11].…”

Section: Discussionmentioning

confidence: 99%

“…Insertion angles of between 25°and 55°to the sagittal plane have been described [1,6,11,12,22,24,27,32,35], with the ideal trajectory varying between levels. Hacker et al [10] have recently performed a CT-based study, assessing whether the contralateral lamina could be used as a landmark.…”

Section: Discussionmentioning

confidence: 99%

“…Over the years, the focus has been on describing cervical pedicle morphology [6,11,14,22,24,27,30,32,35] to give the surgeon as much anatomical information as possible. In 1994, Abumi [1], one of the first surgeons to advocate cervical pedicle screw placement, stated that the angle of insertion should be between 25°and 45°to the sagittal plane, depending on the level at which the surgeon was operating.…”

Section: Introductionmentioning

confidence: 99%

“…In 1994, Abumi [1], one of the first surgeons to advocate cervical pedicle screw placement, stated that the angle of insertion should be between 25°and 45°to the sagittal plane, depending on the level at which the surgeon was operating. Since then, the ideal trajectory has been described as being between 35°and 55° [6,11,22,32] from the sagittal plane.…”

Section: Introductionmentioning

confidence: 99%

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The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

et al. 2009

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Pedicle screws in the sub-axial spine are infrequently used because of concerns over their safety and difficulty in placement, despite their superior pullout strength. In the sub-axial cervical vertebrae, we have observed that the lamina appears to project at right angles to the ipsilateral pedicle axis. The aim of this investigation was to confirm the lamina orientation as a reliable landmark for pedicle screw placement. 80 digital cervical spine CT were analysed. The angle formed by the ipsilateral outer lamina cortex to the pedicle axis was recorded. A total of 398 vertebrae were analysed from patients with a mean age of 39.5 years (range 18-78). Average axial lamina-pedicle angle ranged from 96.6°at C3 to 87.2°at C7 in males, and from 95.6°to 87.5°in females. The angle formed by the posterior cortex of the lamina and the ipsilateral pedicle shows a high level of consistency for subaxial cervical vertebrae ranging from 96°at C3 to 87°at C7. Although the angle is not exactly 90°at all levels as hypothesised, the orientation of the lamina, nevertheless, forms a useful reference plane for insertion of pedicle screws in the sub-axial cervical spine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

et al. 2009

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“…Studies conducted upon the Western population have shown the diameter of the cervical spine to be adequate for screw fixation. 15,16 Various studies have shown a difference between the size of the cervical pedicles in the Western and Asian population. 10,11 Our results demonstrate that anatomical morphometric features of the Graph 5: Mean PW in study subjects cervical pedicles of the studied population are similar to previously reported data but there is a small difference.…”

Section: Discussionmentioning

confidence: 99%

Subaxial Cervical Pedicle Morphometric Assessment in Normal South Indian Subjects using Computed Tomography Scan Images

Murahari¹,

Bhargav²,

Kumar³

et al. 2017

The Journal of Spinal Surgery

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Aim: To conduct a detailed computed tomography (CT) assessment of dimensions of the subaxial cervical spine pedicle in volunteers without any cervical spine pathology. Materials and methods:Sixty-six asymptomatic subjects were analyzed in a single center using cervical spine CT, with imaging reconstruction of each vertebra in axial plane with 1 mm, and in sagittal plane reconstruction with 2 mm slice thickness. Height and weight of each volunteer were measured and body mass index (BMI) was calculated. Parameters, such as pedicle width (PW), pedicle axis length (PAL), pedicle transverse angle (PTA) in axial plane, and pedicle height (PH) in sagittal plane were measured and analyzed. Height and weight of each subject were measured and BMI was calculated as per the formula. Results:The analysis of CT scan images of the cervical spine of 66 asymptomatic subjects with mean age of 45 years with equal distribution of males and females gave mean BMI values as males: 24.58 ± 2.6 and females: 24.03 ± 2.07. Mean values of PAL were smaller in females compared with males, PAL progressively increased from C3 to C6 vertebrae level for both males and females, while C6 and C7 were similar. The PTA showed no gender variation. However, PTA among C3 to C7 demonstrated the same pattern among the left and right pedicles as they had wide angle in the upper subaxial cervical spine, C3 to C6, and became slightly narrow in the lower cervical region at C7. The PH was found to be smaller in females in comparison with males. The PH difference was observed between left and right-side values for men and women, men's right-side values were higher, whereas higher left-side values were observed in females. The PW was found to be smaller in females in comparison with males, PW increased from C3 to C7 vertebrae level, but we found little difference between left side and right side for both men and women. Conclusion:Our results are in correlation with previous studies, but our study showed strong correlation between BMI and PW, and the frequency of subjects with PW < 3.5 mm in our population especially in females is higher, suggesting an increased risk to the neurovascular structures while attempting transpedicular screw technique, especially in females.

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Spine Anatomy

Mandegaran

Quinn-Laurin²

2023

Clinical Atlas of Bone SPECT/CT

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Morphometric Evaluation of Subaxial Cervical Vertebrae for Surgical Application of Transpedicular Screw Fixation

Cited by 50 publications

References 16 publications

The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

Subaxial Cervical Pedicle Morphometric Assessment in Normal South Indian Subjects using Computed Tomography Scan Images

Spine Anatomy

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