Morphometry of typical cervical vertebrae on dry bones and CT scan and its implications in transpedicular screw placemen
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ORIGINAL ARTICLE
Morphometry of typical cervical vertebrae on dry bones and CT scan and its implications in transpedicular screw placement surgery Richa Gupta • Kanchan Kapoor • Anshu Sharma Suman Kochhar • Rajeev Garg
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Received: 17 March 2012 / Accepted: 21 August 2012 / Published online: 9 September 2012 Ó Springer-Verlag 2012
Abstract Background Transpedicular stabilization of subaxial cervical spine is a very delicate procedure that requires thorough understanding of the pedicle anatomy to minimize the rate of neurovascular complications. The current study was conducted to investigate the morphometric details including dimensions and axis of typical cervical vertebrae (C3–C6) for transpedicular screw insertion surgery. Methods The current study was conducted on 100 sides of 50 dry and 160 sides of 80 vertebrae on computerized tomography scans of typical cervical vertebrae. Parameters that were studied bilaterally included distance between medial aspect of the pedicle and dural sac, pedicle height, pedicle width, interpedicular distance, lateral and medial cortical thickness, transverse pedicle angle and chord length. Results Distance between medial aspect of the pedicle and dural sac was found to be 2.2 ± 0.99 mm. Mean pedicle height (6.5 ± 1.1 mm) was found to be greater
than pedicle width (4.9 ± 0.9 mm) in all the vertebrae. Mean transverse pedicle angle and chord length was observed to be 39.4° and 32.1 mm, respectively. Mean interpedicular distance, medial and lateral cortical thickness was observed to be 21.8 ± 1.6, 1.43 ± 0.4 and 0.79 ± 0.2 mm, respectively. Conclusions The present study highlights a threedimensional orientation of subaxial cervical pedicle anatomy, while emphasizing the risks involved in the view of comparatively smaller values of pedicle dimensions of subaxial cervical vertebrae. This knowledge about typical cervical vertebrae, its pedicle and their adjacent neurovascular structures may enhance the safety of transpedicular screw insertion.
R. Gupta Department of Anatomy, PGIMER, Government Medical College and Hospital, Sector-32, Chandigarh, India
Introduction
R. Gupta (&) # 3233, Sector 37-D, Chandigarh 160036, India e-mail: [email protected] K. Kapoor A. Sharma Department of Anatomy, GMCH-32, Government Medical College and Hospital, Sector-32, Chandigarh, India S. Kochhar Department of Radiodiagnosis, GMCH-32, Government Medical College and Hospital, Sector-32, Chandigarh, India R. Garg Department of Neurosurgery, PGIMER, Government Medical College and Hospital, Sector-32, Chandigarh, India
Keywords: Cervical pedicle Medial cortex Morphometry Pedicle screw Surgical anatomy Transpedicular fixation
Transpedicular stabilization of the subaxial cervical spine is highly efficient but a delicate procedure, which requires profound knowledge of the cervical spine anatomy. Several biomechanical and clinical surveys have demonstrated superior stabilization capabilities of this technique in patients with poor bone quality, severe cervical spinal injury or degenerative and
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