Priya Ananya, Narayan Ravi Kant, Ghosh Sanjib Kumar, Sarangi Pradosh Kumar
Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Department of Anatomy, ESIC Medical College & Hospital, Bihta, Patna, Bihar, India.
J Orthop. 2023 Jul 22;43:17-24. doi: 10.1016/j.jor.2023.07.022. eCollection 2023 Sep.
The present study was conducted to collect morphometric data on the lumbar vertebrae pedicles of the adult population from the eastern parts of India and analyse the variations, if any, with other parts of the country and the world.
The retrospective cross-sectional study where lumbar pedicle morphometric data was obtained via dried bone, the 3D Lumbar vertebrae images were obtained by scanning the dried lumbar vertebrae, and the 3D lumbar vertebrae model was generated from a 1 mm thin CT scan slice of the Lumbar spine of patients who were advised to have a CT scan of the abdomen for reasons other than related to the vertebral column. Both linear and angular measurements in the lumbar pedicles were made bilaterally.
The transverse pedicle width is widest at L3 and the narrowest at L2 vertebra bilaterally. The sagittal pedicle width at L4 vertebrae was observed to be the widest bilaterally, while L3 had the narrowest pedicle. The pedicular and body length along the pedicular axis is longer than the central axis at all the lumbar levels. The linear measurement along the pedicular axis was longest at L5 bilaterally via both modes, with a range of 18.2-47.31 mm for bones and 21.03-49.28 mm for CT scan morphometry. The transverse pedicular angle on analysis was observed to increase as one goes down the spine from L1 to L5, with a steep rise between L4 and L5. In contrast, the sagittal pedicular angle decreased as we went caudally toward the L5 vertebrae.
The present study data had significant differences among the values reported in the literature from the different populations for the parameters studied. The data obtained by this study will be highly beneficial for the success of the free-hand technique of pedicle screw insertion.
本研究旨在收集印度东部成年人群腰椎椎弓根的形态测量数据,并分析其与该国其他地区及世界其他地区的差异(如有)。
本回顾性横断面研究通过干燥骨获取腰椎椎弓根形态测量数据,通过扫描干燥腰椎椎体获得三维腰椎图像,并从因非脊柱相关原因建议进行腹部CT扫描的患者腰椎1毫米薄层CT扫描切片生成三维腰椎模型。对腰椎椎弓根进行双侧线性和角度测量。
双侧L3椎体的横径椎弓根最宽,L2椎体最窄。观察到L4椎体的矢状径椎弓根双侧最宽,而L3椎弓根最窄。在所有腰椎水平,沿椎弓根轴的椎弓根和椎体长度均长于中心轴。通过两种方式,沿椎弓根轴的线性测量在双侧L5处最长,骨骼测量范围为18.2 - 47.31毫米,CT扫描形态测量范围为21.03 - 49.28毫米。分析发现,从L1到L5,随着脊柱向下,横径椎弓根角度增大,L4和L5之间急剧上升。相反,随着向L5椎体尾侧移动,矢状径椎弓根角度减小。
本研究数据在所研究参数上与不同人群文献报道的值存在显著差异。本研究获得的数据将对椎弓根螺钉徒手置入技术的成功实施非常有益。