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IJAR.2019.296

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Type of Article:  Original Research

Volume 7; Issue 4.1 (October 2019)

Page No.: 7033-7037

DOI: https://dx.doi.org/10.16965/ijar.2019.296

CT MORPHOMETRY OF TYPICAL CERVICAL VERTEBRAL PEDICLES FOR CLINICAL ACCURACY IN CERVICAL PEDICLE SCREW INSERTION

Saurabh Kulkarni 1, Wasim Hiroli *2,  Arun Kasote 3.

1 Associate Professor Of Anatomy, Govt Medical College , Jalgaon , Maharashtra , India.

*2 Assistant Professor Of Anatomy, Govt Medical College , Jalgaon , Maharashtra , India.

3 Professor & Head ; Dept Of Anatomy, Govt Medical College , Jalgaon , Maharashtra , India.

Corresponding Author: Dr. Wasim Hiroli, Assistant Professor Of Anatomy, Govt Medical College, Jalgaon , Maharashtra , India. E-Mail: jalanat33@gmail.com

ABSTRACT:

Background: Pedicle screw fixation for mid- and lower cervical spine reconstruction has a potential risk of injury to surrounding structures. To achieve optimal surgical outcomes, it is therefore necessary that pertinent anatomical data, especially with regard to pedicles and vertebral bodies be considered prior to surgery.

Methods: 63 patients were scanned using axial CT parallel to the upper endplate of the vertebral body (C3–C6) with a helical CT scanner.  Foramen width (FW), Foramen height (FH), Pedicle width (PW), Foramen angle (FA), Pedicle transverse angle (PTA), Lateral mass angle (LMA) were measured. Mean value and standard deviation of each parameter were calculated.

Results: Mean FW ranged from 5.8 to 6.1 mm with non-significant difference from C3 to C6.The mean FH ranged from 4.9 to 5.1 mm, with non-significant differences between each vertebra. The mean PW ranged from 5.3 to 5.8 mm. There were significant differences between each vertebra, except for the PW between C3 and C4. The FA ranged from 17.5 to 18.5. There were significant differences between each vertebra, except for the FA between C3 and C6. The mean PTA ranged from 39.8 to 35.8.  The mean LMA ranged from 0.9 to 3.1.There were significant differences between each vertebra, except for the LMA between C4 and C5. The FW and FH exhibited no correlations with PW, PTA or LMA. FA was found to be positively correlated with both PTA and LMA. There was also a positive correlation between PTA and LMA.

Conclusion: Anatomical features of the cervical spine using CT to select safer screw insertion techniques are highly recommended. In cases in which insertion of pedicle screws is difficult, Lateral Mass Screw (LMS) can be inserted safely. Whereas when insertion of LMS is difficult, insertion of pedicle screws can be performed easily.

Key words: Pedicle screw fixation, Cervical spine reconstruction, Injury to surrounding structures, Surgical outcomes.

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Cite this article: Saurabh Kulkarni, Wasim Hiroli, Arun Kasote. CT MORPHOMETRY OF TYPICAL CERVICAL VERTEBRAL PEDICLES FOR CLINICAL ACCURACY IN CERVICAL PEDICLE SCREW INSERTION. Int J Anat Res 2019;7(4.1):7033-7037. DOI: 10.16965/ijar.2019.296