Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation

S. P. Mohanty, M. Pai Kanhangad, S. N. Bhat, S. Chawla

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws. Methods: Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae. Results: The lowest (mean ± SD) transverse pedicle width in the lower thoracic spine was 5.4 ± 0.70 mm, whereas in the lumbar spine it was 7.2 ± 0.87 mm. The shortest (mean ± SD) screw path length in lower thoracic pedicles was 35.8 ± 2.10 and 41.9 ± 2.18 mm in the lumbar spine. The mean transverse pedicle angle in the lower thoracic spine was consistently less than 5°, whereas it gradually increased from L1 through L5 from 8.5° to 30°. Forty-one screws violated the pedicle wall, due to erroneous angle of screw insertion. Conclusions: In the current study, pedicle dimensions were smaller compared to the Western population. In Indian patients, pedicle screws of 5 mm diameter and 30 mm length, and 6 mm diameter and 35 mm length can safely be used in the lower thoracic and lumbar spine, respectively. However, it is important to assess the pedicle morphology on imaging prior to pedicle fixation.

Original languageEnglish
Pages (from-to)299-305
Number of pages7
JournalMusculoskeletal Surgery
Volume102
Issue number3
DOIs
Publication statusPublished - 01-12-2018

Fingerprint

Spine
Thorax
Population
Pedicle Screws

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Mohanty, S. P. ; Pai Kanhangad, M. ; Bhat, S. N. ; Chawla, S. / Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation. In: Musculoskeletal Surgery. 2018 ; Vol. 102, No. 3. pp. 299-305.
@article{7649793cd23a47f9a3464f1d48978fe7,
title = "Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation",
abstract = "Purpose: To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws. Methods: Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae. Results: The lowest (mean ± SD) transverse pedicle width in the lower thoracic spine was 5.4 ± 0.70 mm, whereas in the lumbar spine it was 7.2 ± 0.87 mm. The shortest (mean ± SD) screw path length in lower thoracic pedicles was 35.8 ± 2.10 and 41.9 ± 2.18 mm in the lumbar spine. The mean transverse pedicle angle in the lower thoracic spine was consistently less than 5°, whereas it gradually increased from L1 through L5 from 8.5° to 30°. Forty-one screws violated the pedicle wall, due to erroneous angle of screw insertion. Conclusions: In the current study, pedicle dimensions were smaller compared to the Western population. In Indian patients, pedicle screws of 5 mm diameter and 30 mm length, and 6 mm diameter and 35 mm length can safely be used in the lower thoracic and lumbar spine, respectively. However, it is important to assess the pedicle morphology on imaging prior to pedicle fixation.",
author = "Mohanty, {S. P.} and {Pai Kanhangad}, M. and Bhat, {S. N.} and S. Chawla",
year = "2018",
month = "12",
day = "1",
doi = "10.1007/s12306-018-0534-z",
language = "English",
volume = "102",
pages = "299--305",
journal = "Musculoskeletal Surgery",
issn = "2035-5106",
publisher = "Springer Verlag",
number = "3",

}

Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation. / Mohanty, S. P.; Pai Kanhangad, M.; Bhat, S. N.; Chawla, S.

In: Musculoskeletal Surgery, Vol. 102, No. 3, 01.12.2018, p. 299-305.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation

AU - Mohanty, S. P.

AU - Pai Kanhangad, M.

AU - Bhat, S. N.

AU - Chawla, S.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Purpose: To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws. Methods: Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae. Results: The lowest (mean ± SD) transverse pedicle width in the lower thoracic spine was 5.4 ± 0.70 mm, whereas in the lumbar spine it was 7.2 ± 0.87 mm. The shortest (mean ± SD) screw path length in lower thoracic pedicles was 35.8 ± 2.10 and 41.9 ± 2.18 mm in the lumbar spine. The mean transverse pedicle angle in the lower thoracic spine was consistently less than 5°, whereas it gradually increased from L1 through L5 from 8.5° to 30°. Forty-one screws violated the pedicle wall, due to erroneous angle of screw insertion. Conclusions: In the current study, pedicle dimensions were smaller compared to the Western population. In Indian patients, pedicle screws of 5 mm diameter and 30 mm length, and 6 mm diameter and 35 mm length can safely be used in the lower thoracic and lumbar spine, respectively. However, it is important to assess the pedicle morphology on imaging prior to pedicle fixation.

AB - Purpose: To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws. Methods: Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae. Results: The lowest (mean ± SD) transverse pedicle width in the lower thoracic spine was 5.4 ± 0.70 mm, whereas in the lumbar spine it was 7.2 ± 0.87 mm. The shortest (mean ± SD) screw path length in lower thoracic pedicles was 35.8 ± 2.10 and 41.9 ± 2.18 mm in the lumbar spine. The mean transverse pedicle angle in the lower thoracic spine was consistently less than 5°, whereas it gradually increased from L1 through L5 from 8.5° to 30°. Forty-one screws violated the pedicle wall, due to erroneous angle of screw insertion. Conclusions: In the current study, pedicle dimensions were smaller compared to the Western population. In Indian patients, pedicle screws of 5 mm diameter and 30 mm length, and 6 mm diameter and 35 mm length can safely be used in the lower thoracic and lumbar spine, respectively. However, it is important to assess the pedicle morphology on imaging prior to pedicle fixation.

UR - http://www.scopus.com/inward/record.url?scp=85056213746&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056213746&partnerID=8YFLogxK

U2 - 10.1007/s12306-018-0534-z

DO - 10.1007/s12306-018-0534-z

M3 - Article

VL - 102

SP - 299

EP - 305

JO - Musculoskeletal Surgery

JF - Musculoskeletal Surgery

SN - 2035-5106

IS - 3

ER -