Simpson Venita, Clair Brandon, Ordway Nathaniel R, Albanese Stephen A, Lavelle William F
Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY.
Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY.
Spine (Phila Pa 1976). 2016 Nov 15;41(22):1740-1746. doi: 10.1097/BRS.0000000000001628.
Cadaveric in vitro computed tomography (CT) imaging study.
To examine minimum pedicle diameter from transverse and coronal CT reconstructions of thoracolumbar spine specimens and compare their degree of disparity, if any. Pedicle angulation in coronal and transverse planes was measured and their contribution to the disparity in minimum pedicle diameter was assessed.
Spinal minimum pedicle diameter can be obtained from both transverse and coronal CT reconstructions; however, the degree of disparity in these measurements has not been described previously. Angulation of the pedicle in transverse and coronal planes may contribute to a disparity in minimum pedicle diameter acquired from reconstructions. This also has not been described previously. This study examined whether the disparity could be predicted by spinal level, as pedicle angulations vary in both coronal and transverse planes.
Five thoracolumbar specimens (T1-L5, age 48-59 yrs, male) were CT scanned utilizing clinical protocols. Minimum pedicle diameters and pedicle angulations were acquired in transverse and coronal reconstructions. Disparities between minimum pedicle diameters were measured and the correlation between this disparity and spinal level was characterized.
A significant difference (P < 0.001) in minimum pedicle diameter existed between measures from coronal and transverse reconstructions. There was a significant correlation (P < 0.001) between the difference in minimal pedicle diameter and the transverse pedicle angle as well as the coronal pedicle angle.
An overestimation of minimum pedicle diameter in the transverse reconstruction occurs when the coronal pedicle angulation increases, and in the coronal reconstruction when the transverse pedicle angulation increases. Therefore, pedicle angle should be determined using both coronal and transverse reconstructions and utilized to reduce the risk of overestimation of the true pedicle diameter.
NA.
尸体体外计算机断层扫描（CT）成像研究。
通过胸腰椎脊柱标本的横断位和冠状位CT重建图像，检测椎弓根最小直径，并比较其差异程度（若存在差异）。测量冠状面和横断面的椎弓根角度，并评估其对椎弓根最小直径差异的影响。
脊柱椎弓根最小直径可通过横断位和冠状位CT重建图像获得；然而，此前尚未描述这些测量值之间的差异程度。椎弓根在横断位和冠状面的角度可能导致重建图像获得的椎弓根最小直径存在差异。此前也未对此进行描述。本研究探讨了这种差异是否可通过脊柱节段进行预测，因为椎弓根角度在冠状面和横断位均有所不同。
使用临床方案对5个胸腰椎标本（T1-L5，年龄48-59岁，男性）进行CT扫描。在横断位和冠状位重建图像上获取椎弓根最小直径和椎弓根角度。测量椎弓根最小直径之间的差异，并确定该差异与脊柱节段之间的相关性。
冠状位和横断位重建图像测量的椎弓根最小直径存在显著差异（P<0.001）。最小椎弓根直径差异与横断位椎弓根角度以及冠状位椎弓根角度之间存在显著相关性（P<0.001）。
当冠状位椎弓根角度增加时，横断位重建图像会高估椎弓根最小直径；当横断位椎弓根角度增加时，冠状位重建图像会高估椎弓根最小直径。因此，应同时使用冠状位和横断位重建图像确定椎弓根角度，以降低高估真实椎弓根直径的风险。
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