Pisal Tushar, Deshmukh Ashwin, Agrawal Rahul, Gurnani Sagar, Barosani Ankit
Orthopaedics, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Jul 29;16(7):e65631. doi: 10.7759/cureus.65631. eCollection 2024 Jul.
Background Lumbar fusion techniques are vital for treating various spinal conditions by promoting vertebral fusion to alleviate pain and restore stability. Given the anatomical uniqueness of the Indian skeletal structure, this study evaluates the radiological dimensions of lumbar endplates in the Indian population and their correlation with the placement and length of interbody cages used in various lumbar fusion techniques such as oblique lateral lumbar interbody fusion (OLIF), transforaminal lumbar interbody fusion (TLIF), and anterior lumbar interbody fusion (ALIF). This study aimed to conduct radiological measurements of lumbar endplates in the Indian population and correlate them with cage placement and length in lumbar fusion techniques. Methods This prospective study was conducted at the orthopaedic ward of a tertiary care center in Western Maharashtra, India. Healthy individuals (aged >18 years, either gender) selected with a 95% confidence level using Philip Core Integrity software (Amsterdam, Netherlands) were included in the study. We excluded those with a history of low back pain, previous lumbar spine surgeries, fractures, tuberculosis, tumors, deformities, degenerative diseases, or lesions affecting the lumbar spine. Quantitative measurements such as oblique and sagittal diameters, apophyseal ring widths, and interbody cage lengths were calculated using multiplanar reformatting with specific imaging parameters. Results A total of 150 individuals with an average age of 39.83 ± 14.17 years, ranging from 20 to 65 years. Among the study population, 68 were males and 82 were females. Among the male study population, oblique parameters such as Angle AOB and Mid-OD (oblique diameter) show considerable variability, with Angle AOB ranging from 51.43 ± 2.40 mm (L2 inferior) to 31.59 ± 4.25 mm (L5 inferior) and Mid-OD ranging from 41.59 ± 2.59 mm (L3 superior) to 34.38 ± 2.26 mm (S1 superior). Side-sagittal dimensions vary from 32.11 ± 2.50 mm (S1 superior) to 36.48 ±3.26 mm (L3 superior), emphasizing the need for tailored surgical planning. In contrast, females in the study population exhibit distinct anatomical profiles, with Angle AOB ranging from 52.15 ± 2.43 mm (L2 inferior) to 20.45 ± 5.45 mm (S1 superior) and Mid-OD from 33.48 ± 2.15 mm (L3 inferior) to 42.45 ± 2.59 mm (L3 superior). These findings underscore gender-specific anatomical differences crucial for individualized clinical evaluation and treatment strategies. Conclusion This study comprehensively analyzes oblique, side-sagittal, transverse, and midsagittal anatomic parameters across various vertebral levels in men and women, highlighting significant anatomical variations crucial for clinical assessments and surgical interventions.
背景 腰椎融合技术通过促进椎体融合以减轻疼痛并恢复稳定性，对治疗各种脊柱疾病至关重要。鉴于印度骨骼结构的解剖学独特性，本研究评估了印度人群腰椎终板的放射学尺寸，以及它们与各种腰椎融合技术（如斜外侧腰椎椎间融合术（OLIF）、经椎间孔腰椎椎间融合术（TLIF）和前路腰椎椎间融合术（ALIF））中使用的椎间融合器的放置和长度的相关性。本研究旨在对印度人群的腰椎终板进行放射学测量，并将其与腰椎融合技术中融合器的放置和长度相关联。方法 本前瞻性研究在印度马哈拉施特拉邦西部一家三级医疗中心的骨科病房进行。使用飞利浦Core Integrity软件（荷兰阿姆斯特丹）以95%的置信水平选取的健康个体（年龄>18岁，不限性别）纳入本研究。我们排除了有腰痛病史、既往腰椎手术史、骨折、结核、肿瘤、畸形、退行性疾病或影响腰椎的病变的个体。使用具有特定成像参数的多平面重组计算诸如斜径和矢状径、骨突环宽度和椎间融合器长度等定量测量值。结果 共有150名个体，平均年龄为39.83±14.17岁，年龄范围为20至65岁。在研究人群中，男性68名，女性82名。在男性研究人群中，诸如AOB角和中间外径（斜径）等斜向参数显示出相当大的变异性，AOB角范围从51.43±2.40毫米（L2下终板）到31.59±4.25毫米（L5下终板），中间外径范围从41.59±2.59毫米（L3上终板）到34.38±2.26毫米（S1上终板）。侧矢状径尺寸从32.11±2.50毫米（S1上终板）到36.48±3.26毫米（L3上终板）不等，强调了定制手术规划的必要性。相比之下，研究人群中的女性表现出不同的解剖学特征，AOB角范围从52.15±2.43毫米（L2下终板）到20.45±5.45毫米（S1上终板），中间外径从33.48±2.15毫米（L3下终板）到42.45±2.59毫米（L3上终板）。这些发现强调了性别特异性解剖学差异对个体化临床评估和治疗策略至关重要。结论 本研究全面分析了男性和女性不同椎体水平的斜向、侧矢状、横向和矢状中解剖参数，突出了对临床评估和手术干预至关重要的显著解剖学变异。
