A CT-Guided Analysis of the Morphology of the Thoracolumbar Pedicles in A South Indian Population

Abstract

Background: Pedicle screw fixation is a method of choice to treat spinal instabilities. Pre- operative CT scan measurements are important in determining the screw sizes in accordance to the pedicle measurements. A mis-sized screw can violate the pedicle leading to breaches. Context and purpose of study: Present literature shows pedicle measurement studies in caucasian population. The study in Indian population are sparce. This study aims to assess the morphology of thoracolumbar pedicle parameters bilaterally using CT scans of patients and to compare the measurements between genders in a south Indian population. Results: Gender-based variations were observed in the pedicle width for upper thoracic vertebrae (T1-T5). Screw path length was consistent in thoracic and lumbar vertebrae except T11, L1, and L2 which showed significant differences in mean between genders and screw path angle showed a significant variation in vertebrae T1, T8-T12 and L5. Bilateral symmetry was present in screw path length of thoracic vertebrae and asymmetry was noted in L2-L3 among males. Correlation was observed to be strong bilaterally with high reliability in pedicle measurements. Conclusions: This study helps to understand gender-based variations in morphology of thoracolumbar pedicle which is important for enhancing pedicle screw fixation outcomes in spinal surgeries and reducing complications. KEYWORDS: pedicle, morphology, computed tomography, thoracolumbar, transpedicular screw fixation.