Analysing lumbar pedicle morphometry observed via traditional and recent modalities

Abstract

ObjectiveThe present study was conducted to collect morphometric data on the lumbar vertebrae pedicles of the adult population from the eastern parts of India and analyse the variations, if any, with other parts of the country and the world. MethodsThe retrospective cross-sectional study where lumbar pedicle morphometric data was obtained via dried bone, the 3D Lumbar vertebrae images were obtained by scanning the dried lumbar vertebrae, and the 3D lumbar vertebrae model was generated from a 1 mm thin CT scan slice of the Lumbar spine of patients who were advised to have a CT scan of the abdomen for reasons other than related to the vertebral column. Both linear and angular measurements in the lumbar pedicles were made bilaterally. ResultsThe transverse pedicle width is widest at L3 and the narrowest at L2 vertebra bilaterally. The sagittal pedicle width at L4 vertebrae was observed to be the widest bilaterally, while L3 had the narrowest pedicle. The pedicular and body length along the pedicular axis is longer than the central axis at all the lumbar levels. The linear measurement along the pedicular axis was longest at L5 bilaterally via both modes, with a range of 18.2–47.31 mm for bones and 21.03–49.28 mm for CT scan morphometry. The transverse pedicular angle on analysis was observed to increase as one goes down the spine from L1 to L5, with a steep rise between L4 and L5. In contrast, the sagittal pedicular angle decreased as we went caudally toward the L5 vertebrae. ConclusionThe present study data had significant differences among the values reported in the literature from the different populations for the parameters studied. The data obtained by this study will be highly beneficial for the success of the free-hand technique of pedicle screw insertion.