Abstract
BackgroundSpinal surgery requires an intimate understanding of pedicle morphology to provide safe and effective outcomes. Although current research has attempted to identify morphological vertebral pedicle trends, no study has utilized computed tomography (CT) scans to compare the lumbar transverse pedicle angle (TPA) with patient demographics factors in a diverse population throughout multiple hospital centers.MethodsAnalysis of randomly selected CT scans from L1-L5 of 97 individuals who underwent imaging over a two-week period for non-back pain related complaints was conducted. Measuring 970 TPAs in total allowed for comparison of each patients’ pedicle angle with important patient specific demographics including ethnicity, age, gender, height and weight. Statistical analysis utilized multiple comparisons of demographics at each level with post-hoc Bonferroni correction analysis to compare demographics at each level.ResultsWith relation to gender, age, height or weight, no statistically significant differences were identified for TPAs at any vertebral level. However, when stratified by ethnicity, the differences in transverse pedicle angles averages (TPA –Avg) at L2 and L3 were found to be statistically significant (p < 0.05).ConclusionWe have identified a previously unknown and significant relationship between ethnicity and TPA at lumbar vertebral levels. These findings provide critical information that may be added to the operating surgeons’ knowledge of pedicle morphology. We hope this novel information can assist in preoperative planning of pedicle screw placement and potentially help improve surgical outcomes.
Highlights
Spinal surgery requires an intimate understanding of pedicle morphology to provide safe and effective outcomes
For each individual lumbar segment, the transverse pedicle angle (TPA) mean with respect to ethnicity was reported with each corresponding standard error and is displayed graphically (Fig. 2)
When stratified by ethnicity, the TPA averages at individual vertebral levels were found to be statistically significant at the L2 and L3 levels (p < 0.05)
Summary
Spinal surgery requires an intimate understanding of pedicle morphology to provide safe and effective outcomes. Current research has attempted to identify morphological vertebral pedicle trends, no study has utilized computed tomography (CT) scans to compare the lumbar transverse pedicle angle (TPA) with patient demographics factors in a diverse population throughout multiple hospital centers. With advancing trends and technologies in surgery, there is an increased impetus to advance patient outcomes by improving operative techniques and lumbar fusion is no exception [4, 5]. With the increasing use of posterior lumbar fusion, further elucidation of patient specific variables in relation to vertebral morphometric variation may assist orthopedic surgeons in planning and performance of spinal surgery. A better understanding of anatomic variability offers to improve patient safety by increasing the surgeons’ precision while performing spinal fusion procedures. The TPA is the angle created between a line drawn from the midline of the spinous process to the anterior vertebral
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