Department of Orthopedics Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Road, Luzhou, 646000, Sichuan, China.
Department of Orthopedics, Zigong Fourth People's Hospital, 19 Tan Mulin Street, Zigong, 643000, Sichuan, China.
BMC Musculoskelet Disord. 2022 Mar 30;23(1):306. doi: 10.1186/s12891-022-05264-2.
No study has assessed the feasibility and safety of cervical pedicle screw implantation in patients with vertebral artery dominance (VAD), a common vertebral artery (VA) variation which can increase VA injury (VAI) risk. This study was to assess morphological characteristics of the subaxial cervical pedicles and surrounding critical structures, and identify their correlations in patients with VAD.
Computed tomography arteriography scans of 152 patients were used for retrospectively measuring parameters including pedicle outer width (POW), the distance from the lateral pedicle border to the closest part of VA (DPVA), diameter of VA (DVA), area of VA (AVA), area of transverse foramen (ATF) and occupational ratio of transverse foramen (TF). Moreover, correlations among some critical parameters were assessed.
One hundred eight males and 44 females, with a mean age of 55.9 years were included. POW was smaller on the dominant side than on the non-dominant side, whereas DPVA, DVA, AVA, ATF, and TF were larger on the dominant side than those on the non-dominant side. On both sides, POW < 4 mm and POW + DPVA < 5 mm were observed most frequently at C3 and C4. On both sides, POW was correlated to ATF, and ATF was correlated to DVA and AVA. DPVA was correlated to ATF on the dominant side.
Patients with VAD exhibited smaller POW on the dominant side, most frequently at C3 and C4. Dominant VA may indirectly affect POW. TF may be a key determinant of DPVA and POW.
尚无研究评估椎动脉优势（vertebral artery dominance，VAD）患者颈椎椎弓根螺钉植入的可行性和安全性，而 VAD 是一种常见的椎动脉变异，可增加椎动脉损伤（vertebral artery injury，VAI）风险。本研究旨在评估 VAD 患者下颈椎椎弓根及其周围关键结构的形态学特征，并确定它们之间的相关性。
回顾性分析 152 例患者的 CT 血管造影扫描数据，测量椎弓根外宽（pedicle outer width，POW）、从椎弓根外侧缘到最近椎动脉部分的距离（distance from the lateral pedicle border to the closest part of vertebral artery，DPVA）、椎动脉直径（vertebral artery diameter，DVA）、椎动脉面积（vertebral artery area，AVA）、横突孔面积（transverse foramen area，ATF）和横突孔职业比（transverse foramen occupation ratio，TF）等参数。此外，评估了一些关键参数之间的相关性。
152 例患者中，男 108 例，女 44 例，平均年龄 55.9 岁。优势侧 POW 小于非优势侧，而 DPVA、DVA、AVA、ATF 和 TF 则相反，优势侧大于非优势侧。在两侧，C3 和 C4 最常见 POW < 4mm 和 POW+DPVA < 5mm。两侧 POW 与 ATF 相关，而 ATF 与 DVA 和 AVA 相关。优势侧 DPVA 与 ATF 相关。
VAD 患者优势侧 POW 较小，最常见于 C3 和 C4。优势椎动脉可能间接影响 POW。TF 可能是 DPVA 和 POW 的关键决定因素。
