Abstract
BackgroundSafe placement of pedicle screws without jeopardizing neurovascular structures medially and anteriorly is important during spine surgery. Inferior breach of pedicle is also dangerous due to low margin of error. Lumbar morphology and identical pedicle orientation at L1 to L5 shown on CT scan of young Taiwanese patients (90 patients) were analyzed and compared with findings reported for Caucasian subjects.MethodsPreviously reported techniques were employed to quantitatively elucidate the parameters regarding lumbar morphology and identical pedicle orientation at each vertebra. The parameters for pedicle angle (PA), pedicle diameter (PD), pedicle axis distance (PAD), midline axis distance (MAD), transverse pedicle axis distance (TPAD) and transverse intertangential angle (TITA) were measured.ResultsTaiwanese subjects had different PA, PD, PAD, MAD at L1 to L5 and TITA at L3 to L5 compared with Caucasian subjects. L5 had the most convergent pedicle axis, the widest PD and the shortest antero-posterior axis morphology.ConclusionsThis study provides detailed information for identifying pedicle orientation during pedicle screw placement and elucidate racial differences in lumbar morphology and pedicle orientation between Taiwanese and Caucasian populations.
Highlights
Safe placement of pedicle screws without jeopardizing neurovascular structures medially and anteriorly is important during spine surgery
Posterior approaches with transpedicular pedicle screw placement for lumbar spines have been proved to be practical, safe, and effective in the treatment of degenerative disease, trauma, scoliosis, infection and tumor
According to the inclusion criteria, 78 patients were selected for L1, 81 for L2, 77 for L3, 78 for L4 and 73 for L5 measurements
Summary
Safe placement of pedicle screws without jeopardizing neurovascular structures medially and anteriorly is important during spine surgery. Posterior approaches with transpedicular pedicle screw placement for lumbar spines have been proved to be practical, safe, and effective in the treatment of degenerative disease, trauma, scoliosis, infection and tumor [1]. Two common methods clinically used for pedicle screw placement were Roy-Camille [3] and Weinstein [4] methods, which were advocated using different anatomic landmarks (Fig. 1). The Roy-Camille method [3] was advocated at the landmark of medial of the accessory process and 1 mm below the facet joint. The Weinstein method [4] was advocated at the lateral and inferior corner of the superior articular face. The Weinstein method for pedicle screw fixation is commonly used in
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