Quantitative morphometric study of the subaxial cervical vertebrae end plate

Feng, Hao; Fang, Xiangyi; Huang, Dageng; Yu, Chengcheng; Zhao, Siqi; Hao, Dingjun

doi:10.1016/j.spinee.2016.09.019

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Various morphological studies, as well as the present study, have revealed that the cervical endplate is not simply flat (10,(19)(20)(21); rather, most IEPs are arched (10,21). Although most SEPs are considered relatively flat, they still exhibit a concave depth of 0.39-0.69 mm (19,20). Therefore, the flat end of conventional TMCs do not match well with the endplate, leading to a very small contact area and high stress concentration at the TEI (4,7,10).…”

Section: Discussionsupporting

confidence: 65%

“…Various morphological studies, as well as the present study, have revealed that the cervical endplate is not simply flat ( 10 , 19-21 ); rather, most IEPs are arched ( 10 , 21 ). Although most SEPs are considered relatively flat, they still exhibit a concave depth of 0.39-0.69 mm ( 19 , 20 ).…”

Section: Discussionsupporting

confidence: 60%

“…However, 4.2% of the TEIs still exhibited a large interval (>1 mm, grade III); thus, their mechanical strength may decrease. In some cases, mismatch is inevitable; matching 100% of the endplates for a fixed-shape AA-TMC is impossible due to the large variations in endplate radius, concave depth and concave apex location among cervical endplates ( 10 , 19-21 ).…”

Section: Discussionmentioning

confidence: 99%

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Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

Teng

Gao

et al. 2021

Exp Ther Med

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Mismatch between the titanium mesh cage and cervical geometries is an important factor that induces subsidence in anterior cervical corpectomy and fusion (ACCF). The aim of the present study was to construct a new quadrate anatomically adaptive titanium mesh cage (AA-TMC) that matches well with the cervical geometries and segmental alignment in one-and two-level ACCF. Computed tomography (CT) scans of 54 individuals were used to measure the cervical endplate geometries. X-rays of 74 young individuals were used to measure the intervertebral body angle (IBA) and intervertebral body height (IBH) of the surgical segments. The AA-TMC was designed based on these measured parameters. A total of 18 cervical cadaveric specimens underwent successive oneand two-level ACCF using the AA-TMC. Postoperatively, the specimens underwent CT scanning to assess the degree of matching of the TMC-endplate interface (TEI), IBA and IBH. A TEI interval <0.5 mm was considered well matching. In the sagittal plane, 93.8% of the inferior endplates were arched, whereas 94.8% of the superior endplates were flat. In the coronal plane, 82.9% of the inferior endplates and 93.8% of the superior endplates were flat. A total of 91.7 and 94.4% of the TEIs were well matched in one-and two-level ACCF, respectively. The postoperative IBA and IBH values were consistent with the values of young individuals. The AA-TMC achieved good matching with cervical geometries and segmental alignment in one-and two-level ACCF, and is proposed for use in ACCF to increase the contact at the TEI and achieve sufficient lordosis restoration.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

Teng

Gao

et al. 2021

Exp Ther Med

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“…[21,22] Hence, the prostheses should have a footprint as large as possible to dissipate the load evenly, rather than in concentrated areas. [23] Although a few studies have reported quantified data regarding the endplate geometry, [11,12,24–26] data concerning the quantitative relation between the compact rim and the much less resistant cancellous tissue in the central area is very scarce, which can help to define the exact contact area of disc prosthesis and endplate. Different from previous studies, the present study conveniently and accurately measured the endplates by introducing an optical 3D range scanning system and a reverse engineering software, which allowed not only the quantification of concavity, but also separate measurements of the central endplate and the epiphyseal rim.…”

Section: Discussionmentioning

confidence: 99%

A morphometric study of the middle and lower cervical vertebral endplates and their components

Feng

Fang²,

Huang³

et al. 2017

Medicine

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Cervical disc arthroplasty is a common method of treating cervical degenerative disease. However, the footprints of most prosthesis dimensions are obtained from data of Caucasian individuals. Besides, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. We aimed to detail the three-dimensional (3D) anatomic morphology of the subaxial cervical vertebral endplate, utilizing high-precision, high-resolution scanning equipment, and provide a theoretical basis for designing appropriate disc prostheses for Chinese patients.A total of 138 cervical vertebral endplates were studied. Each endplate was digitized using a non-contact optical 3D range scanning system and then reconstructed to quantify diameters and surface area for the whole endplate and its components (central endplate and epiphyseal rim). The whole endplate and mid-plane concavity depth were measured.There is marked morphologic asymmetry, in that the cranial endplate is more concave than the corresponding caudal endplate, with endplate concavity depths of 2.04 and 0.69 mm, respectively. For the caudal endplates, the endplate concavity apex locations were always located in the posterior portion (81.42%), while in cranial endplates relatively even. The central endplate was approximately 60% of the area of the whole endplate and the anterior section of the ring was the widest. From C3/4 down to C6/7 discs, the vertebral endplate gradually became more elliptical. Chinese cervical endplate anatomic sizes are generally smaller than that of Caucasians. Although Korean and Chinese individuals both belong to the Asian population subgroup, the majority of anatomic dimensions differ. Singaporean cervical endplate morphology is very similar to that of Chinese patients.We performed a comprehensive and accurate quantitative description of the cervical endplate, which provide references to shape and profile an artificial cervical disc without sacrificing valuable bone stock. To design a device with footprint as large as possible to distribute the axial load, we suggest that additional attention should be paid to the marginal rim. It is essential to specifically design appropriate disc prosthesis for Chinese patients. To fit the morphologic and biomechanical variations, we also propose that the disc prostheses for different vertebral segments should be separately designed.Abbreviations: 3D = three-dimensional, APD = the anteroposterior diameter, ECD = the whole endplate concavity depth, ECL = the endplate concavity apex location, SCD = the mid-sagittal plane concavity depth, SCL = the sagittal concavity apex, TD = the transverse diameter.

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“…One of the superior approaches of arthrodesis is Trans-pedicular screw. There is a need for detailed anatomical knowledge in the Indian population as the instrumentation involves damage to various vital structures, and also there is a variability in vertebral dimensions amongst different races [12][13][14][15][16][17][18][19] thus causing difficulty in the standardization of measurements. The characteristic of a typical cervical vertebrae is the presence of transversely elongated bodies.…”

Section: Discussionmentioning

confidence: 99%

Morphometric analysis of typical cervical vertebral pedicle - An osteological study

Devaraj¹,

RR²,

Nallan³

et al. 2017

Int. J. Orthop. Sci.

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Background: Successful placement of cervical pedicle screws requires accurate identification of entry point, trajectory and appropriate size of implant. Studies and guidelines regarding the direction of pedicle screw insertion and pedicle dimensions in Indian population are very limited and hence the objective of our study was to do Morphometric analysis of Typical Cervical Vertebral pedicle (C3 to C6) Materials and Methods: Osteological study of the pedicle was performed in 100 typical (C3-C6) dry bone specimens. The vertebral pedicles were evaluated by measuring its height, width, length, lateral mass + pedicle length, total pedicle axis length and transverse pedicle angle. Results: In our study, the mean pedicle length of C3, C4, C5, C6 was 6.04, 5.48, 5.30, and 5.92 respectively. The mean pedicle height in our study ranged from 5.05 mm (C3) to 5.86 mm (C6). The Range of Mean pedicle width was from 4.79 to 5.16 mm. The mean lateral mass + pedilce length ranged from 11.17 to 13.18 mm while the mean total pedicle axis length ranged from 27.05 to 30.04 mm. Conclusions: We found that there were high individual variations. The pedicle dimensions were relatively smaller in Indians compared to previous studies in other population. This mandates preoperative CT evaluation of pedicle and smaller size pedicle screws customized according to pedicle dimensions of Indians.

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Quantitative morphometric study of the subaxial cervical vertebrae end plate

Cited by 9 publications

References 23 publications

Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

A morphometric study of the middle and lower cervical vertebral endplates and their components

Morphometric analysis of typical cervical vertebral pedicle - An osteological study

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