Srivastava Abhishek, Mahajan Rajat, Nanda Ankur, Nanda Geetanjali, Mishra Nirajana, Kanagaraju Vijayant, Batra Sahil, Chhabra Harvinder Singh
Department of Spine Services, Primus Hospital, Chanakyapuri, New Delhi, India.
Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India.
Asian Spine J. 2017 Oct;11(5):679-685. doi: 10.4184/asj.2017.11.5.679. Epub 2017 Oct 11.
A retrospective computed tomography (CT)-based morphometric study of 84 C1pedicles in an Indian population focusing on critical morphometric dimensions vis-a-vis C1 pedicle screw placement.
To determine the feasibility of C1 pedicle screw placement in an Indian population and propose a novel classification system for the same.
At present, C1 pedicle screws are rarely used, and very few studies have focused on the feasibility of pedicle screw placement in terms of racial, gender, and ethnic variations in anatomical structures. There are no CT-based data on C1 pedicles that assess the feasibility of pedicle screw placement in the Indian population.
We measured C1 pedicle diameter on CT coronal scan images of 42 adult patients. Extramedullary height (EMH) and intramedullary height (IMH) were measured. We examined the differences between the right and left atlas pedicles and compared measures between males and females. These data were analyzed using significance tests. Based on the results, we propose a novel classification system, which we believe will help in determining the feasibility of C1 pedicle screw placement.
Forty-two adult patients (84 pedicles) were examined. Average EMH and IMH were 4.48±0.91 and 0.86±0.77, respectively. Approximately, 32% of the C1 pedicles had bone thicknesses of <4 mm, 49% had IMH of <1 mm, and 38% had no pedicles. The average thickness in women was 4.21±0.93 mm, which was significantly thinner than that in men (4.73±0.81 mm, =0.004). Right and left pedicles were not significantly different.
Our data indicate that approximately one-third of the Indian population may not be suitable candidates for C1 pedicle screw placement. Caution should be exercised while placing type 1B and type 2 pedicles based on our proposed classification system.
一项基于计算机断层扫描（CT）的回顾性形态测量研究，对印度人群中的84个C1椎弓根进行研究，重点关注与C1椎弓根螺钉置入相关的关键形态学尺寸。
确定在印度人群中置入C1椎弓根螺钉的可行性，并为此提出一种新的分类系统。
目前，C1椎弓根螺钉很少使用，很少有研究关注在解剖结构的种族、性别和民族差异方面椎弓根螺钉置入的可行性。尚无基于CT的关于C1椎弓根的数据来评估在印度人群中置入椎弓根螺钉的可行性。
我们在42例成年患者的CT冠状位扫描图像上测量C1椎弓根直径。测量髓外高度（EMH）和髓内高度（IMH）。我们检查了寰椎左右椎弓根之间的差异，并比较了男性和女性之间的测量值。使用显著性检验对这些数据进行分析。基于结果，我们提出了一种新的分类系统，我们认为这将有助于确定C1椎弓根螺钉置入的可行性。
检查了42例成年患者（84个椎弓根）。平均EMH和IMH分别为4.48±0.91和0.86±0.77。大约32%的C1椎弓根骨厚度<4mm，49%的IMH<1mm，38%没有椎弓根。女性的平均厚度为4.21±0.93mm，明显薄于男性（4.73±0.81mm，P=0.004）。左右椎弓根无显著差异。
我们的数据表明，大约三分之一的印度人群可能不适合置入C1椎弓根螺钉。根据我们提出的分类系统，在置入1B型和2型椎弓根时应谨慎。
