Stockton Robert, Albano Joseph, Lentz Jonathon, Ganz Maximillian, Grewal Kanwarpaul, Katsigiorgis Gus
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, 888 Old country road, Plainview, NY, 11803, USA.
NYIT College of Osteopathic Medicine, Old Westbury, NY, USA.
BMC Musculoskelet Disord. 2019 Mar 18;20(1):114. doi: 10.1186/s12891-019-2507-2.
Spinal surgery requires an intimate understanding of pedicle morphology to provide safe and effective outcomes. Although current research has attempted to identify morphological vertebral pedicle trends, no study has utilized computed tomography (CT) scans to compare the lumbar transverse pedicle angle (TPA) with patient demographics factors in a diverse population throughout multiple hospital centers.
Analysis of randomly selected CT scans from L1-L5 of 97 individuals who underwent imaging over a two-week period for non-back pain related complaints was conducted. Measuring 970 TPAs in total allowed for comparison of each patients' pedicle angle with important patient specific demographics including ethnicity, age, gender, height and weight. Statistical analysis utilized multiple comparisons of demographics at each level with post-hoc Bonferroni correction analysis to compare demographics at each level.
With relation to gender, age, height or weight, no statistically significant differences were identified for TPAs at any vertebral level. However, when stratified by ethnicity, the differences in transverse pedicle angles averages (TPA -Avg) at L2 and L3 were found to be statistically significant (p < 0.05).
We have identified a previously unknown and significant relationship between ethnicity and TPA at lumbar vertebral levels. These findings provide critical information that may be added to the operating surgeons' knowledge of pedicle morphology. We hope this novel information can assist in preoperative planning of pedicle screw placement and potentially help improve surgical outcomes.
脊柱手术需要深入了解椎弓根形态,以实现安全有效的手术效果。尽管目前的研究已尝试确定椎弓根形态学趋势,但尚无研究利用计算机断层扫描(CT)在多个医院中心的不同人群中比较腰椎横椎弓根角度(TPA)与患者人口统计学因素。
对97例在两周内因非背痛相关症状接受影像学检查的患者的L1 - L5进行随机选择的CT扫描分析。总共测量970个TPA,以便将每个患者的椎弓根角度与重要的患者特定人口统计学因素(包括种族、年龄、性别、身高和体重)进行比较。统计分析采用各水平人口统计学的多重比较及事后Bonferroni校正分析,以比较各水平的人口统计学因素。
在任何椎体水平,TPA在性别、年龄、身高或体重方面均未发现统计学上的显著差异。然而,按种族分层时,发现L2和L3的横椎弓根角度平均值(TPA - Avg)差异具有统计学意义(p < 0.05)。
我们发现了种族与腰椎水平TPA之间此前未知的显著关系。这些发现提供了关键信息,可补充手术医生对椎弓根形态的认识。我们希望这一新颖信息能有助于椎弓根螺钉置入的术前规划,并可能有助于改善手术效果。