The Prevalence and Distribution of Vertebral Pedicles in Adolescent Idiopathic Scoliosis in Chinese people: A Computed Tomography–Based Study of 2958 Vertebral Pedicles

Abstract

To explore the prevalence and distribution of abnormal vertebral pedicles in adolescent idiopathic scoliosis (AIS) in Chinese people. We retrospectively reviewed AIS patients at a single institution between 2011 and 2017. Transverse pedicle widths from T1 to L5 were measured carefully using computed tomography, including cancellous and cortical channels. Pedicle morphology was classified as: type A, a cancellous channel larger than 4 mm; type B, a cancellous channel measuring 2-4 mm; type C, a cancellous channel smaller than 2 mm with an entirely cortical channel of 2 mm or greater; or type D, a cortical channel smaller than 2 mm. Types B, C, and D were defined as abnormal. Prevalence and distribution of abnormal pedicles were assessed. Eighty-seven patients with AIS, with a total of 2958 vertebral pedicles, were carefully measured and classified. The total prevalence of abnormal vertebral pedicles was as high as 65%, with type B comprising 40%, type C comprising 23%, and type D comprising 2%. Pedicles were located between T2 and T10 in 84% of type C and 91% of type D cases. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles. There is a significantly high prevalence of abnormal pedicles in AIS in Chinese people, with a total prevalence of 65%. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles.