Simple jQuery Dropdowns
Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/2703
Title: Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation
Authors: Pongsthorn Chanplakorn
Chaiwat Kraiwattanapong
Kitti Aroonjarattham
Pittavat Leelapattana
Gun Keorochana
Suphaneewan Jaovisidha
Wiwat Wajanavisit
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Orthopedics
Keywords: Open Access article;Cervical pedicle;Cervical pedicle screw;Anatomy;Pedicle dimensions;Cervical spine fixation
Issue Date: 2014
Citation: BMC Musculoskeletal Disorders. Vol. 15, (2014), 125
Abstract: Background: Cervical pedicle screw (CPS) insertion is a technically demanding procedure. The quantitative understanding of cervical pedicle morphology, especially the narrowest part of cervical pedicle or isthmus, would minimize the risk of catastrophic damage to surrounding neurovascular structures and improve surgical outcome. The aim of this study was to investigate morphology and quantify cortical thickness of the cervical isthmus by using Multi-detector Computerized Tomography (MD-CT) scan. Methods: The cervical CT scans were performed in 74 patients (37 males and 37 females) with 1-mm slice thickness and then retro-reconstructed into sagittal and coronal planes to measure various cervical parameters as follows: outer pedicle width (OPW), inner pedicle width (IPW), outer pedicle height (OPH), inner pedicle height (IPH), pedicle cortical thickness, pedicle sagittal angle (PSA), and pedicle transverse angle (PTA). Results: Total numbers of 740 pedicles were measured in this present study. The mean OPW and IPW significantly increased from C3 to C7 while the mean OPH and IPH of those showed non-significant difference between any measured levels. The medial-lateral cortical thickness was significantly smaller than the superior-inferior one. PTA in the upper cervical spine was significantly wider than the lower ones. The PSA changed from upward inclination at upper cervical spine to the downward inclination at lower cervical spine. Conclusions: This study has demonstrated that cervical vertebra has relatively small and narrow inner pedicle canal with thick outer pedicle cortex and also shows a variable in pedicle width and inconsistent transverse angle. To enhance the safety of CPS insertion, the entry point and trajectories should be determined individually by using preoperative MD-CT scan and the inner pedicle width should be a key parameter to determine the screw dimensions.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/2703
metadata.dc.identifier.url: http://www.biomedcentral.com/1471-2474/15/125
Appears in Collections:RA-Article

Files in This Item:
File Description SizeFormat 
ra-ar-wiwat-2014.pdf642.28 kBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.