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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2011, Number 6

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Acta Ortop Mex 2011; 25 (6)

Morphometric analysis of cervical pedicles in a Mexican population

Vargas-Mena R, Dufoo-Olvera M, García-López OF, López-Palacios JJ, Aburto-Trejo JA, Carranco-Toledo GA

Language: Spanish
References: 18
Page: 366-371
PDF size: 56.17 Kb.


ABSTRACT

Background: Knowledge of the morphometric anatomy of cervical pedicles is essential for the safe and accurate placement of pedicle screws during instrumentation of the cervical spine. Screw placement in the lumbar and thoracic vertebrae is considered as a safe practice, unlike the cervical vertebrae due to the risks involved. There are few reports on this technique. The little available information comes from populations different from the Mexican population. Knowing the measurements of each cervical vertebra will provide proper screw orientation and selection at the time of screw placement. Methods: Prospective, cross-sectional, descriptive study in subjects who presented at the outpatient and emergency services. Patient’s in whom a CAT scan of the cervical spine was ordered as part of the work-up protocol, from April 1st 2010 to October 31st 2010, were included. A morphometric anatomic study was undertaken using the CAT software. In a saggital view: a) Saggital angle, b) Saggital diameter. In an axial view: a) Work distance, b) Cross-sectional angle and c) Cross-sectional diameter. Results: The following measurements were obtained for each segment from C2 to C7: mean, standard deviation, range and minimal and maximal values. Conclusions and clinical relevance: Appropriate preoperative planning prior to cervical transpedicular instrumentation is essential to achieve greater accuracy during screw placement. The information obtained allows performing the procedure. As a result of this, a report based on out center’s experience may be disseminated thus sharing our technique with the medical community.


REFERENCES

  1. Ebraheim N, Xu R, Knight T, Yeasting R: Morphometric evaluation of lower cervical pedicle and its projection. Spine 1997; 22: 1-6.

  2. Hasegawa K, Hirano T, Shimoda H, Homma T, Morita O: Indications for cervical pedicle screw instrumentation in nontraumatic lesions. Spine 2008; 33: 2284-9.

  3. Kothe R, Rüther W, Schneider E, Linke B: Biomechanical analysis of transpedicular screw fixation in the subaxial cervical spine. Spine 2004; 29: 1869-75.

  4. Kowalski J, Ludwig S, Hutton W, Heller J: Cervical spine pedicle screws. A biomechanical comparison of two insertion techniques. Spine 2000; 25: 2865-7.

  5. Kramer DL, Ludwig SC, Balderston RA, et al: Placement of pedicle screws in the cervical spine: Comparative accuracy of cervical pedicle screw placement using three techniques. Orthop Trans 1997; 21: 484.

  6. Hasegawa K, Hirano T, Shimoda H, Homma T, Morita O: Indications for cervical pedicle screw instrumentation in nontraumatic lesions. Spine 2008; 33: 2284-9.

  7. Karaikovic E, Yingsakmongkol W, Gaines R: Accuracy of cervical pedicle screw placement using the funnel technique. Spine 2001; 26: 2456-62.

  8. Abumi K, Yasuhiro S, Ito M, Taneichi H, et al: Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine 2000; 25: 962-9.

  9. Olsewski JM, Simmons EH, Kallen FC, et al: Morphometry of the lumbar spine: anatomical perspectives related to transpedicular fixation. J Bone Joint Surg Am 1990; 72: 541–9.

  10. Pai BS, Gangadhara, Nirmala S, Muralimohan S, Varsha SM: Morphometric analysis of the thoracic pedicle: An anatomic-radiological study. Neurol India 2010; 58: 253-8.

  11. Bozbuga M, Ozturk A, Ari Z, et al: Morphometric evaluation of subaxial cervical vertebrae for surgical application of transpedicular screw fixation. Spine 2004; 29: 1876-80.

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

  13. McLain R, Ferrara L, Kabins M: Pedicle morphometry in the upper thoracic spine–Limits to safe screw placement in older patients. Spine 2002; 27: 2467-71.

  14. Ludwig S, Kramer D, Balderston R, Vaccaro A, et al: Placement of pedicle screws in the human cadaveric cervical spine. Comparative accuracy of three techniques. Spine 2000; 25: 1655-67.

  15. Kim HS, Heller J, Hudgins P, Fountain J: The accuracy of computed tomography in assessing cervical pedicle screw placement. Spine 2003; 21: 2441-6.

  16. Sakamoto T, Neo M, Nakamura T: Transpedicular screw placement evaluated by axial computed tomography of the cervical pedicle. Spine 2004; 29: 2510-4.

  17. Rampersaud R, Simon D, Foley K: Accuracy Requirements for Image-Guided spinal pedicle screw placement. Spine 2001; 26: 352-9.

  18. Karaikovic E, Daubs M, Madsen R, Gaines R: Morphologic characteristics of human cervical pedicles. Spine 1997; 22: 493-500.




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