open access

Vol 78, No 3 (2019)
ORIGINAL ARTICLES
Published online: 2019-01-23
Submitted: 2018-11-22
Accepted: 2019-01-10
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Computed tomography measurement of the bone matrix of vertebral pedicle and its clinical significance

X. Li, X. Wang, S. Gao, H. En, Y. Zhang, H. Wang, Y. Cai, Z. Wang, Z. Li, C. Zhang, J. Ma, S. Zhang
DOI: 10.5603/FM.a2019.0009
·
Pubmed: 30687913
·
Folia Morphol 2019;78(3):476-480.

open access

Vol 78, No 3 (2019)
ORIGINAL ARTICLES
Published online: 2019-01-23
Submitted: 2018-11-22
Accepted: 2019-01-10

Abstract

Background: To provide the anatomic basis for the clinical application of the transpedicular screw fixation.

Materials and methods: Thirty spine (C2–L5) specimens were used. The width of the pedicle cortex and width of the pedicle medullary cavity (WPC and WPMC), and the height of the pedicle cortex and height of the pedicle medullary cavity (HPC and HPMC) were measured at the isthmus of the pedicle using computed

tomography (CT) scanning.

Results: Width of the pedicle medullary cavity changed in a three-dovetailed-saddle shape with four peaks and three valleys, namely C2 (high), C4`5 (low), T2 (high), T4 (the lowest), T12 (high), L1 (low) and L5 (the highest). HPMC of the cervical pedicle changed in a saddle shape, gradually increasing from C5–L5. WPC, WPMC, HPC and HPMC showed a regular change, respectively. In each segment, the superior border of the pedicle cortex had a nearly consistent thickness to the interior border within an identical pedicle, while the pedicle cortex thickness radio of the medial and lateral border was nearly 3:1 among the cervical pedicles, 2:1 among thoracic pedicles, and 1:1 among lumbar pedicles.

Conclusions: Both HPMC and WPMC are the dominant factors for the choice of screw diameter, but HPMC should also be considered in C2–T1 pedicles, especially C6 and C7. Additionally, the screw for C3–6 or T4–6 pedicles should be about 3.0 mm in diameter.

Abstract

Background: To provide the anatomic basis for the clinical application of the transpedicular screw fixation.

Materials and methods: Thirty spine (C2–L5) specimens were used. The width of the pedicle cortex and width of the pedicle medullary cavity (WPC and WPMC), and the height of the pedicle cortex and height of the pedicle medullary cavity (HPC and HPMC) were measured at the isthmus of the pedicle using computed

tomography (CT) scanning.

Results: Width of the pedicle medullary cavity changed in a three-dovetailed-saddle shape with four peaks and three valleys, namely C2 (high), C4`5 (low), T2 (high), T4 (the lowest), T12 (high), L1 (low) and L5 (the highest). HPMC of the cervical pedicle changed in a saddle shape, gradually increasing from C5–L5. WPC, WPMC, HPC and HPMC showed a regular change, respectively. In each segment, the superior border of the pedicle cortex had a nearly consistent thickness to the interior border within an identical pedicle, while the pedicle cortex thickness radio of the medial and lateral border was nearly 3:1 among the cervical pedicles, 2:1 among thoracic pedicles, and 1:1 among lumbar pedicles.

Conclusions: Both HPMC and WPMC are the dominant factors for the choice of screw diameter, but HPMC should also be considered in C2–T1 pedicles, especially C6 and C7. Additionally, the screw for C3–6 or T4–6 pedicles should be about 3.0 mm in diameter.

Get Citation

Keywords

vertebral pedicle; bony cortex; medullary cavity; screw diameter

About this article
Title

Computed tomography measurement of the bone matrix of vertebral pedicle and its clinical significance

Journal

Folia Morphologica

Issue

Vol 78, No 3 (2019)

Pages

476-480

Published online

2019-01-23

DOI

10.5603/FM.a2019.0009

Pubmed

30687913

Bibliographic record

Folia Morphol 2019;78(3):476-480.

Keywords

vertebral pedicle
bony cortex
medullary cavity
screw diameter

Authors

X. Li
X. Wang
S. Gao
H. En
Y. Zhang
H. Wang
Y. Cai
Z. Wang
Z. Li
C. Zhang
J. Ma
S. Zhang

References (7)
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  2. Koktekir E, Toktas ZO, Seker A, et al. Anterior transpedicular screw fixation of cervical spine: Is it safe? Morphological feasibility, technical properties, and accuracy of manual insertion. J Neurosurg Spine. 2015; 22(6): 596–604.
  3. Li J, Zhao L, Qi F, et al. hree-dimensional finite-element study on anterior transpedicular screw fixation system of the subaxial cervical spine. Zhonghua Wai Ke Za Zhi. 2015; 53(11): 841–846.
  4. Ninomiya K, Iwatsuki K, Ohnishi YI, et al. Radiological evaluation of the initial fixation between cortical bone trajectory and conventional pedicle screw technique for lumbar degenerative spondylolisthesis. Asian Spine J. 2016; 10(2): 251–257.
  5. Srivastava SK, Nemade PS, Aggarwal RA, et al. Congenital absence of posterior elements of C2 vertebra with atlanto-axial dislocation and basilar invagination: a case report and review of literature. Asian Spine J. 2016; 10(1): 170–175.
  6. Tang X, Cao Q, Chen L, et al. Anatomic study on entry point and implant technique for C2 pedicle screw fixation. hongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015; 29(2): 175–178.
  7. Wu H, Chen Y, Zhang C, et al. [Application of percutaneous pedicle screw fixation for lumbar degenerative disease]. Zhonghua Yi Xue Za Zhi. 2014; 94(23): 1764–1768.

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