Morphometry of the Lower Thoracic and Lumbar Pedicles and its Relevance in Pedicle Fixation

Mohanty, SP and Pai, Kanhangad M and Bhat, SN and Chawla, S (2018) Morphometry of the Lower Thoracic and Lumbar Pedicles and its Relevance in Pedicle Fixation. Musculoskeletal Surgery, 102 (1). pp. 1-7. ISSN 2035-5106

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Abstract

Purpose To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws.Methods Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae.Results The lowest (mean ± SD) transverse pedicle width in the lower thoracic spine was 5.4 ± 0.70 mm, whereas in thelumbar spine it was 7.2 ± 0.87 mm. The shortest (mean ± SD) screw path length in lower thoracic pedicles was 35.8 ± 2.10 and 41.9 ± 2.18 mm in the lumbar spine. The mean transverse pedicle angle in the lower thoracic spine was consistently less than 5°, whereas it gradually increased from L1 through L5 from 8.5° to 30°. Forty-one screws violated the pedicle wall, due to erroneous angle of screw insertion. Conclusions In the current study, pedicle dimensions were smaller compared to the Western population. In Indian patients,pedicle screws of 5 mm diameter and 30 mm length, and 6 mm diameter and 35 mm length can safely be used in the lower thoracic and lumbar spine, respectively. However, it is important to assess the pedicle morphology on imaging prior to pedicle fixation

Item Type: Article
Uncontrolled Keywords: Thoracolumbar spine; Spinal injuries; Pedicle screws; Pedicle morphology
Subjects: Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Library
Date Deposited: 21 Feb 2018 04:21
Last Modified: 21 Feb 2018 04:21
URI: http://eprints.manipal.edu/id/eprint/150611

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