The feasibility of transpedicular screw fixation of the subaxial cervical spine in the Arab population: a computed tomography-based morphometric study.

Osama Al-Saeed,Mehraj Sheikh,Osama Rabie Kombar,Yousef Marwan,Ahmed Samir

doi:10.1007/s10195-016-0396-9

Abstract

BackgroundTranspedicular screw fixation of the cervical spine provides excellent biomechanical stability. The feasibility of inserting a 3.5-mm screw in the pedicle requires a minimum pedicle diameter of 4.5 mm. This diameter allows at least 0.5 mm bony bridge medially and laterally in order to avoid pedicle violation which can result in neurovascular complications. We aim to evaluate the feasibility of this technique in Arab people since no data are available about this population.Materials and methodsThis cross-sectional study involved a retrospective review of computed tomography scans of normal cervical spines of 99 Arab adults. Ten morphometric measurements were obtained. Data were analyzed using a p value of ≤0.05 as the cut-off level of statistical significance.ResultsOur sample included 63 (63.6 %) males and 36 (36.4 %) females, with a mean age of 35.5 ± 16.5 years. The morphometric parameters of C3–C7 spine pedicles were larger in males than in females. The outer pedicle width (OPW) was <4.5 mm in >25 % of all subjects at C3–C6 vertebrae. Statistically significant differences in the OPW between males and females were noted at C3 (p = 0.032) and C6 (p = 0.004).ConclusionsInserting pedicle screws in the subaxial cervical spine is feasible among the majority of Arab people.Level of evidenceLevel 3.

Highlights

Numerous conditions of the cervical spine, such as trauma, deformities, tumors and osteoarthritis, require rigid fixation and solid fusion of the vertebral segments in order to achieve good treatment results
A statistically significant difference in outer pedicle height (OPH) and inner pedicle height (IPH) between males and females was noted from C3 to C7 (p values ranged from 0.042 to\0.001)
A statistically significant difference was noted in the superior pedicle distance (SPD) between males and females at all C3–C7 levels (p value ranged 0.027–0.001); males had larger SPD than females

Summary

Introduction

Numerous conditions of the cervical spine, such as trauma, deformities, tumors and osteoarthritis, require rigid fixation and solid fusion of the vertebral segments in order to achieve good treatment results. Placing screws in the pedicles provides a better bony purchase compared to other techniques of spine fixation, leading to higher biomechanical stability [3, 4]. The feasibility of inserting a 3.5-mm screw in the pedicle requires a minimum pedicle diameter of 4.5 mm This diameter allows at least 0.5 mm bony bridge medially and laterally in order to avoid pedicle violation which can result in neurovascular complications. We aim to evaluate the feasibility of this technique in Arab people since no data are available about this population. Materials and methods This cross-sectional study involved a retrospective review of computed tomography scans of normal cervical spines of 99 Arab adults. Data were analyzed using a p value of B0.05 as the cut-off level of statistical significance

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Conclusion