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ISSN 2306-4102 (Impreso)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2012, Número 6

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Acta Ortop Mex 2012; 26 (6)


Fijación vertebral por vía transpedicular. Importancia de los estudios anatómicos y de imagen

Morales-Ávalos R, Elizondo-Omaña RE, Vílchez-Cavazos F, Martínez-Ponce de León AR, Elizondo-Riojas G, Delgado-Brito M, Cortés-González P, Guzmán-Avilán RI, Pinales-Razo R, de la Garza-Castro O, Guzmán-López S

Idioma: Español
Referencias bibliográficas: 87
Paginas: 402-411
Archivo PDF: 166.19 Kb.


RESUMEN

El número de pacientes que padecen patología de la columna vertebral se ha incrementado exponencialmente en los últimos años y con ello, se incrementará el número de casos que requerirán tratamiento quirúrgico. En la actualidad la cirugía de fusión vertebral por vía transpedicular representa la técnica de fijación más comúnmente utilizada para el tratamiento de desordenes vertebrales de cualquier índole. Las características morfométricas de las vértebras, en especial del pedículo, determinan el tamaño de los implantes pediculares tanto en anchura como en longitud, así como la forma, dirección y angulación ideal del tornillo al momento de su introducción. Es importante el conocimiento de estas características para evitar lesiones de estructuras importantes adyacentes, así como para disminuir la incidencia de complicaciones postoperatorias. En las últimas décadas se han efectuado numerosos estudios en distintas poblaciones sobre las características morfométricas del pedículo vertebral para determinar sus dimensiones reales mediante medición directa y métodos de imagen. Estos estudios han llegado a la conclusión de que existen diferencias significativas en estas mediciones entre las diferentes etnias, razas, géneros, edades y regiones vertebrales estudiadas. En el presente artículo se analizan los diferentes estudios morfométricos del pedículo y demás elementos vertebrales estudiados en México y el resto del mundo, justificando la importancia de su conocimiento y aplicación quirúrgica para el correcto desarrollo de la cirugía de fusión vertebral por vía transpedicular.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Christodolou AG, Apostolou T, Ploumis A, Terzidis I, Hantzokos I, Pournaras J: Pedicle dimensions of the thoracic and lumbar vertebrae in the Greek population. Clin Anat 2005; 18: 404-8.

  2. Santoni BA, Hynes RA, McGilvray KC, et al: Cortical bone trajectory for lumbar pedicle screws. Spine 2008; 10: 200-8.

  3. Jiménez-Ávila JM, Calderón-Granados A, Bitar-Alatorre WE: Costo directo de las lesiones en la columna. Cir Cir 2012; 80(5): 435-41.

  4. Prakash L, Latha VP, Rajanigandha V, Mangala MP, Anu VR, Gajendra S: Morphometry of vertebral pedicles: a comprehensive anatomical study in the lumbar region. Int J Morphol 2007; 25(2): 393-406.

  5. Arman C, Naderi S, Kiray A, Aksu FT, Yilmaz HS, Tetik S: The human sacrum and safe approaches for screw placement. J Clin Neurosci 2009; 16: 1046-9.

  6. Lien SB, Liou NH, Wu SS: Analysis of anatomic morphometry of the pedicles and the safe zone for through-pedicle procedures in the thoracic and lumbar spine. Eur Spine J 2007; 16: 1215-22.

  7. Gómez de la Riva A, Isla A, Pérez-López C, Ortega R, Fernández-Miranda JC, Heredero J: Causas de reintervención quirúrgica en pacientes con fijación lumbar intervenidos por estenosis de canal. Neurocirugía 2006; 17: 232-9.

  8. Li G, Guohua L, Passias P, et al: Complications associated with thoracic pedicle screws in spinal deformity. Eur Spine J 2010; 19: 1576-84.

  9. Faraj AA, Webb JK: Early complications of spinal pedicle screw. Eur Spine J 1997; 6: 324-6.

  10. Olmos A, Villas C, Beguristan JL, Zubieta JL: Morfometría vertebral en población española. Rev Ortop Traumatol 2002; 2: 158-64.

  11. Okutan O, Kaptanoglu E, Solaroglu I, Beskonakli E, Tekdemir I: Determination of the length of anteromedial screw trajectory by measuring interforaminal distance in the first sacral vertebrae. Spine 2004; 29: 1608-11.

  12. Femenias-Roselló JM, Estella-Ripoll GJ, Rubi-Jaime M, Llabrés-Comamala M: Injury to the gonadal, renal and duodenal veins during pedicle screw extraction surgery. Rev Esp Cir Ortop Traumatol 2009; 53(5): 340-3.

  13. Liljengvist UR, Link TM, Halm HF: Morphometric analysis of thoracic and lumbar vertebrae in idiopathic scoliosis. Spine 2000: 25(10): 1247-53.

  14. Pal GP, Routal RV: Transmission of weight through lower thoracic and lumbar region of vertebral column in man. J Anat 1987; 152: 93-105.

  15. Misenhimer G, Peek R, Wiltse L, Rothman S, Widell E: Anatomic analysis of pedicle cortical and cancellous diameter as related to screw size. Spine 1989; 14: 367-72.

  16. Karabekir HS, Gocmen-Mas N, Edizer M, Ertekin T, Yazici C, Atamturk D: Lumbar vertebra morphometry and stereological assesment of intervertebral space volumetry: a methodological study. Ann Anat 2011; 193(3): 231-6.

  17. Chazono M, Tanaka T, Kumagae Y, Sai T, Marumo K: Ethnic differences in pedicle and bony spinal canal dimensions calculated from computed tomography of the cervical spine: a review of the English-language literature. Eur Spine J 2012; 21: 1451-8.

  18. Urrutia-Vega E, Elizondo-Omaña RE, De la Garza-Castro O, Guzmán-López S: Morphometry of the pedicle and vertebral body in a Mexican population by CT and fluoroscopy. Int J Morphol 2009; 27(4): 1299-303.

  19. Bazaldúa CJJ, González LA, Gómez SA, et al: Morphometric study of cervical vertebrae C3-C7 in a population form Northeastern Mexico. Int J Morphol 2011; 29(2): 325-30.

  20. Xu R, Nabil A, Ebraheim NA, Skie M: Pedicle screw fixation in the cervical spine. Am J Orthop 2008; 37(8): 403-8.

  21. Cruz-Conde R, Castel Oñate A, Sánchez-Benítez FJ, Ríos-García B: Anterior approach for traumatic lesions of the lower cervical spine: long-term results. Rev Esp Cir Ortop Traumatol 2010; 54(1): 3-12.

  22. Liu YJ, Tian W, Liu B, et al: Comparison of the clinical accuracy of cervical (C2-C7) pedicle screw insertion assisted by fluoroscopy, computed tomography-based navigation, and intraoperative three-dimensional C-arm navigation. Chinese Med J 2010; 123(21): 2295-8.

  23. Ma XY, Yin QS, Wu ZH, Xia H, Liu JF, Zhong SZ: Anatomic considerations for the pedicle screw placement in the first cervical vertebra. Spine 2005; 30(13): 1519-23.

  24. Simsek S, Yigitkanli K, Seckin H, et al: Ideal screw entry point and projection angles for posterior lateral mass fixation of the atlas: an anatomical study. Eur Spine J 2009; 18: 1321-5.

  25. Goksin S, Hakan-Hadi K: Morphometric anatomy of the atlas and axis vertebrae. Turkish Neurosurgery 2006; 16(2): 69-76.

  26. Neo M, Fujibayashi S, Miyata M, Takemoto M, Nakamura T: Vertebral artery injury during cervical spine surgery. A survey of more than 5600 operations. Spine 2008; 33(7): 779-85.

  27. Naderi S, Arman C, Guevencer M, et al: Morphometric analysis of the C2 body and odontoid process. Turkish Neurosurgery 2006; 16(1): 14-8.

  28. Panjabi MM, Shin EK, Chen NC, Wang JL: Internal morphology of human cervical pedicles. Spine 2000; 25(10): 1197-205.

  29. Sieradzki JP, Karaikovic EE, Lautenschlager EP, Lazarus ML: Preoperative imaging of cervical pedicles: comparison of accuracy of oblique radiographs versus axial CT scans. Eur Spine J 2008; 17: 1230-6.

  30. Yusof MI, Ming LK, Abdullah MS: Computed tomographic measurement of cervical pedicles for transpedicular fixation in a Malay population. J Orthop Surg 2007; 15(2): 187-90.

  31. Abuzayed B, Tutunculer B, Kucukyuruk B, Tuzgen S: Anatomic basis of anterior and posterior instrumentation of the spine: morphometric study. Surg Radio Anat 2010; 32(1): 75-85.

  32. Ludwig SC, Kramer DL, Balderston RA, Vaccaro AR, Foley KF, Albert TJ: Placement of pedicle screws in the human cadaveric cervical spine. Spine 2000; 13: 1655-67.

  33. Tan SH, Teo EC, Chua HQ: Quantitative three-dimensional anatomy of cervical, thoracic and lumbar vertebrae of Chinese Singaporeans. Eur Spine J 2004; 13: 137-46.

  34. Reinhold M, Magerl F, Rieger M, Blauth M: Cervical pedicle screw placement: feasibility and accuracy of two new insertion techniques based on morphometric data. Eur Spine J 2007; 16: 47-56.

  35. Kayalioglu G, Erturk M, Varol T, Cezayirli E: Morphometry of the cervical vertebral pedicles as a guide for transpedicular screw fixation. Neurol Med Chir 2007; 47: 102-8.

  36. Rao RD, Marawar SV, Stemper BD, Yoganandan N, Shender BS: Computerized tomographic morphometric analysis of subaxial cervical spine pedicles in young asymptomatic volunteers. J Bone Joint Surg Am 2008; 90: 1914-21.

  37. Ruofu Z, Suilin Y, Xiaoyun H, et al: CT evaluation of cervical pedicle in a Chinesse population for surgical application of transpedicular screw placement. Surg Radiol Anat 2008; 30: 389-96.

  38. Vargas-Mena R, Dufoo-Olvera M, García-López OF, López-Palacios JJ, Aburto-Trejo JA, Carranco-Toledo GA: Análisis morfométrico de los pedículos cervicales en una población mexicana. Act Ortop Mex 2011; 25(6): 366-71.

  39. Fujimoto T, Sei A, Taniwaki T, Okada T, Yakushiji T, Mizuta H: Pedicle screw diameter selection for safe insertion in the thoracic spine. Eur J Orthop Surg Traumatol 2012; 22: 351-6.

  40. Wang VY, Chin CT, Lu DC, Smith JS, Chou D: Free-hand thoracic pedicle screws placed by neurosurgery residents: a CT analysis. Eur Spine J 2010; 19: 821-7.

  41. Yong SC, Young JK, Hyeong-Joong Y, Young-Joon K: Pedicle morphometry for thoracic screw fixation in ethnic Koreans: radiological assessment using computed tomographic myelography. J Korean Neurosurg Soc 2009; 46: 317-21.

  42. Panjabi MM, O`Holleran JD, Crisco JJ, Kothe R: Complexity of the thoracic spine pedicle anatomy. Eur Spine J 1997; 6: 19-24.

  43. Beck M, Rotter R, Gradl G, et al: Reliability and consequences of intraoperative 3D imaging to control positions of thoracic pedicle screws. Arch Orthop Trauma Surg 2012; 14(2): 169-73.

  44. Lu S, Zhang YJ, Wang Z, et al: Accuracy and efficacy of thoracic pedicle screws in scoliosis with patient-specific drill template. Med Biol Eng Comput 2012; 50: 751-8.

  45. Chan CYW, Kwam MK, Saw LB: Thoracic pedicle screw insertion in Asian cadaveric specimen: does radiological pedicle profile affect outcome. Surg Radiol Anat 2011; 33: 19-25.

  46. Di-Silvestre M, Parisini P, Lolli F, Bakaloudis G: Complications of thoracic pedicle screws in scoliosis treatment. Spine 2007; 32(15): 1655-61.

  47. Elliott MJ, Slakey JB: Thoracic pedicle screw placement. Analysis using anatomical landmarks without image guidance. J Pediatr Orthop 2007; 27(5): 582-6.

  48. Changkun Z, Qishan H, Yuezheng H, Xiangyang W, Wei C: Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinesse inmature thoracic spine. Int Orthop 2009; 33: 1663-8.

  49. Jun-Hak K, Gyeong-Mi C, In-Bok C, Sung-Ki A, Joon-Ho S, Hyun-Chul C: Pedicular and extrapedicular morphometric analysis in the Korean population: computed tomographic assessment relevance to pedicle and extrapedicle screw fixation in the thoracic spine. J Korean Neurosurg Soc 2009; 46: 181-8.

  50. Zhuang Z, Chen Y, Han H, et al: Thoracic pedicle morphometry in different body height population. A three-dimensional study using reformatted computed tomography. Spine 2011; 36(24): 1547-54.

  51. Cui G, Watanabe K, Hosogane N: Morphologic evaluation of the thoracic vertebrae for safe free-hand pedicle screw placement in adolescent idiopathic scoliosis: a CT-based anatomical study. Surg Radiol Anat 2012; 34: 209-16.

  52. Datir SP, Mitra SR: Morphometric study of the thoracic vertebral pedicle in an Indian population. Spine 2004; 29: 1174-81.

  53. Vaccaro AR, Rizzolo SJ, Balderston RA, et al: Placement of pedicle screws in the thoracic spine. Part 2: An anatomical and radiographic assessment. J Bone Joint Surg 1995; 77(8): 1200-6.

  54. Chen Y, Zeng J, Guan J: Reformatted computed tomographic evaluation of the thoracic pedicle in a Chinese population for the surgical application of transpedicular screw placement. Surg Radiol Anat 2010; 32: 463-8.

  55. Dvorak M, MacDonald S, Gurr KR, Bailey SI, Haddad RG: An anatomical, radiographic and biomechanical assessment of extrapedicular screw fixation in the thoracic spine. Spine 1993; 18: 1689-94.

  56. Husted DS, Yue JJ, Fairchild TA, Haims AH: An extrapedicular approach to the placement of screws in the thoracic spine: an anatomical and radiographic assessment. Spine 2003; 28: 2324-30.

  57. Husted DS, Haims AH, Fairchild TA, Kershaw TS, Yue JJ: Morphometric comparison of the pedicle rib unit to pedicles in the thoracic spine. Spine 2004; 29(2): 139-46.

  58. Vougioukas VI, Weber J, Scheufler KM: Clinical and radiological results after parapedicular screw fixation of the thoracic spine. Neurosurg Spine 2005; 3: 283-7.

  59. Zindrick MR, Wiltse LL, Doornik A, et al: Analysis of the morphometric characteristics of the thoracic and lumbar pedicles. Spine 1987; 12:160-6.

  60. Sjotrom L, Jacobnson O, Karstrom G, Pech P, Rauschning W: CT analysis of pedicle and screws tracts after implant removal in thoracolumbar fractures. J Spinal Disord 1993; 6: 225-31.

  61. Maillot C, Wolfram-Gabel R: Pedicles of lumbar vertebrae. Surg Radiol Anat 1993; 15: 295-300.

  62. Delfino HL, Benites-Vendrame JR: Morphometric study of lumbar vertebrae’s pedicle. Acta Ortop Bras 2007; 15(4): 183-6.

  63. Inceoglu S, Burghardt A, Akbay A, Majumdar S, McLain RF: Trabecular architecture of lumbar vertebral pedicle. Spine 2005; 30(13): 1485-90.

  64. Kothe R, O’Holeran JD, Liu W, Panjabi MM: Internal architecture of the lumbar pedicle. An anatomic study. Spine 1996; 21: 264-70.

  65. Nojiri K, Matsumoto M, Chiba K, Toyama Y: Morphometric analysis of the thoracic and lumbar spine in Japanese on the use of pedicle screws. Surg Radiol Anat 2005; 27: 123-8.

  66. Kang KS, Song KS, Lee JS, Yang JJ, Song IS: Comparison of radiographic and computed tomographic measurement of pedicle and vertebral body dimensions in Koreans: the radio of pedicle transverse diameter to vertebral body transverse diameter. Eur Spine J 2011; 20: 414-21.

  67. Amonoo-Kuofi: Age-related variations in the horizontal and vertical diameters of the pedicles of the lumbar spine. J Anat 1995; 186: 321-8.

  68. Singel TC, Patel MM, Gohil DV: A study of width and height of lumbar pedicles in Saurashtra region. J Anat Soc India 2004; 53(1): 4-9.

  69. Olsewski JM, Simmons EH, Kallen FC, Mendel FC, Severin CM, Berens AD: Morphometry of the lumbar spine: anatomical perspectives related to transpedicular fixation. J Bone Joint Surg 1990; 72(4): 541-9.

  70. Wolf A, Shoham M, Michael S, Moshe R: Morphometric study of the human lumbar spine for operation-workspace specifications. Spine 2001; 22: 2472-7.

  71. Maaly MA, Saad A, Houlel MME: Morphological measurements of lumbar pedicles in Egyptian population using computerized tomography and cadaver direct caliber measurements. EJRNM 2010; 41: 475-81.

  72. Acharya S, Dorje T, Srivastava A: Lower dorsal and lumbar pedicle morphometry in, Indian population. A study of four hundred fifty vertebrae. Spine 2010; 35(10): 378-84.

  73. Gu Y, Xu R, Ebraheim NA, Rezcallah AT, Yeasting RA: The quantitative study of the lateral region to the lumbar pedicle. Surg Neurol 1999; 52: 35-6.

  74. Esses SI, Sachs BL, Dreyzin V: Complications associated with the technique of pedicle screw fixation. Spine 1993; 18: 2231-39.

  75. Sato K, Kikuchi S: An anatomic study of foraminal nerve root lesions in the lumbar spine. Spine 1993; 18: 2246-51.

  76. Ebraheim NA, Rollins JR, Xu R, Yeasting RA: Projection of the lumbar pedicle and its morphometric analysis. Spine 1996; 21: 1296-1300.

  77. Ebraheim NA, Xu R, Ahmad M, Yeasting RA: Projection of the thoracic pedicle and its morphometric analysis. Spine 1997; 22: 233-8.

  78. Castro WH, Halm H, Jerosch J, Malms J, Steinbeck J, Blasius S: Accuracy of pedicle screw placement in lumbar vertebrae. Spine 1996; 21: 1320-4.

  79. Weinstein JN, Spratt KF, Spengler D: Spine pedicle fixation: reliability and ability of roentgenogram-based assessment and surgical factors on successful screw placement. Spine 1988; 13: 1012-8.

  80. Chawla K, Sharma M, Abhaya A, Kochhar S: Morphometry of the lumbar pedicle in North West India. Eur J Anat 2011; 15(3): 155-61.

  81. Xu R, Ebraheim NA, Gove NK: Surgical anatomy of the sacrum. Am J Orthop 2008; 37(10): 177-81.

  82. Esenkaya I: A morphologic evaluation of the sacroiliac joint and plate fixation on a pelvis model using a S1 pedicular screw, transiliosacral screws, and a compression rod for sacroiliac joint injuries. Act Orthop Traumatol Turc 2002; 36: 432-41.

  83. Ebraheim NA, Lu J, Yang H, Heck BE, Yeasting RA: Anatomical considerations of the second sacral vertebrae and dorsal screw placement. Surg Radiol Anat 1997; 19: 353-7.

  84. Basaloglu H, Turgut M, Taser FA, Ceylan T, Basaloglu HK, Ceylan AA: Morphometry of the sacrum for clinical use. Surg Radiol Anat 2005; 27: 467-71.

  85. Okutan O, Kaptanoglu E, Solaroglu I, Beskonakli E, Tekdemir I: Pedicle morphology of the first sacral vertebrae. Neuroanatomy 2003; 2: 16-9.

  86. Ebraheim NA, Xu R, Biyani A, Nadaud MC: Morphologic considerations of the first sacral pedicle for iliosacral screw placement. Spine 1997; 22: 841-6.

  87. Esses SI, Botsford DJ, Huler RJ: Surgical anatomy of the sacrum: a guide for rational screw fixation. Spine 1991; 16: 286-8.




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