Department of Neurosurgery, The Jikei University School of Medicine, Nishi-Shinbashi 3-25-8, Minato-ku, Tokyo, 105-8461, Japan.
Surg Radiol Anat. 2021 Jun;43(6):833-842. doi: 10.1007/s00276-021-02707-8. Epub 2021 Feb 16.
Pedicle morphology is important for intraoperative surgical anatomy and to define pedicle screw design and parameters. However, differences of pedicle size according to ethnicity and gender are not well studied. The purpose of this study is to investigate morphological characteristics of the pedicle in Japanese patients for determining adequate screw size and optimal surgical planning.
We investigated thoracic and lumbar pedicle morphology in Japanese patients using computed tomography (CT) measurements and analyzed the standard size of pedicles on upper thoracic to lumbar spine CT images in 227 Japanese patients.
Gender had a larger impact on the shape and size of pedicles than racial differences. In the distribution of pedicle width, we calculated the ratio of values less than 4.5 mm, that in females resulted to be over 30% for the Th3-Th9 segment, and particularly high, above 60% at Th4 and Th5.
Our measurement analysis showed that pedicle morphological parameters in Japanese patients showed tendency to be smaller to those found in other studies, and particularly in female patients, they were statistically significantly smaller. Adequate transpedicular instrumentation for Japanese patients will require smaller size pedicle-related devices that will match our anatomical findings to achieve safe device placement. In addition, serving ethnically non-homogenous patient population can require further to spinal morphometric for precise device selection.
椎弓根形态对于术中手术解剖学非常重要，并且可以确定椎弓根螺钉的设计和参数。然而，种族和性别对椎弓根大小的影响尚未得到充分研究。本研究的目的是调查日本患者的椎弓根形态特征，以确定合适的螺钉尺寸和最佳手术计划。
我们使用计算机断层扫描（CT）测量来研究日本患者的胸椎和腰椎椎弓根形态，并分析了 227 例日本患者胸椎至腰椎 CT 图像上椎弓根的标准尺寸。
性别对椎弓根的形状和大小的影响大于种族差异。在椎弓根宽度的分布中，我们计算了小于 4.5mm 值的比例，在女性中，Th3-Th9 节段的比例超过 30%，特别是在 Th4 和 Th5 节段，比例超过 60%。
我们的测量分析表明，日本患者的椎弓根形态参数比其他研究中发现的要小，特别是女性患者，统计学上明显更小。为日本患者提供足够的经椎弓根内固定需要与我们的解剖学发现相匹配的更小尺寸的椎弓根相关器械，以实现安全的器械放置。此外，为了精确选择器械，服务于种族非同质的患者群体可能需要进一步进行脊柱形态计量学研究。
