Pluemvitayaporn Tinnakorn, Kaewmano Tassana, Kunakornsawat Sombat, Surapuchong Suttinont, Ratanakoosakul Warot, Tiracharnvut Kitjapat, Pruttikul Pritsanai, Piyasakulkaew Chaiwat, Kittithamvongs Piyabuth
Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Research Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Asian J Neurosurg. 2024 Dec 2;20(1):132-137. doi: 10.1055/s-0044-1800812. eCollection 2025 Mar.
The surgical management of adolescent idiopathic scoliosis (AIS) often incorporates the utilization of pedicle screws, which are three-column construct devices. A comprehensive understanding of the pedicle morphology is essential for determining the appropriate pedicle screw diameter. While previous studies have examined pedicle morphology in Lenke type 1 AIS, there is a scarcity of information about the pedicle morphology in Lenke type 5 AIS, especially in the Thai population. The aim of this study is to analyze the morphology of the thoracolumbar pedicle, specifically the pedicle width and trajectory length on both the concave and convex sides within a sample of the Thai population diagnosed with Lenke type 5 AIS. In this study, we used computed tomography (CT) measurements to examine the thoracolumbar pedicle morphology in Lenke type 5 AIS patients in the Thai population. We also analyzed the pedicle width and trajectory length on both concave and convex sides in 112 AIS patients with Lenke type 5 curvature. A total of 3,808 pedicles from 112 consecutive AIS patients of Lenke type 5 were enrolled in the study. It was observed that the transverse pedicle width was notably smaller on the concave side compared with the convex side in the apical region of the thoracolumbar spine (T12 to L2). Additionally, the pedicle width of T3 was also found to be significantly smaller on the concave side. Moreover, it was noted that the pedicle trajectory length is significantly longer on the concave side, indicating that the concave side in the apical region may have the capacity to accommodate a slightly longer pedicle screw at T3, T6, L2, L3, and L4. Our analysis of measurements indicates that the thoracolumbar pedicle morphology in Lenke type 5 AIS among the Thai population typically shows smaller widths and longer trajectory lengths on the concave side. This information enhances our understanding of the appropriate selection of pedicle screw diameter and length for treating Lenke type 5 AIS in the Thai population.
青少年特发性脊柱侧凸（AIS）的手术治疗通常会使用椎弓根螺钉，这是一种三柱结构装置。全面了解椎弓根形态对于确定合适的椎弓根螺钉直径至关重要。虽然先前的研究已经考察了Lenke 1型AIS的椎弓根形态，但关于Lenke 5型AIS，尤其是泰国人群的椎弓根形态信息却很匮乏。
本研究的目的是分析胸腰椎椎弓根的形态，特别是在诊断为Lenke 5型AIS的泰国人群样本中，凹侧和凸侧的椎弓根宽度及轨迹长度。
在本研究中，我们使用计算机断层扫描（CT）测量来检查泰国人群中Lenke 5型AIS患者的胸腰椎椎弓根形态。我们还分析了112例Lenke 5型脊柱侧凸AIS患者凹侧和凸侧的椎弓根宽度及轨迹长度。
本研究共纳入了112例连续的Lenke 5型AIS患者的3808个椎弓根。结果发现，在胸腰椎脊柱（T12至L2）的顶椎区域，凹侧的椎弓根横向宽度明显小于凸侧。此外，还发现T3的凹侧椎弓根宽度也明显更小。而且，注意到凹侧的椎弓根轨迹长度明显更长，这表明在顶椎区域的凹侧在T3、T6、L2、L3和L4处可能有能力容纳稍长的椎弓根螺钉。
我们的测量分析表明，泰国人群中Lenke 5型AIS的胸腰椎椎弓根形态通常在凹侧显示出更小的宽度和更长的轨迹长度。这些信息增进了我们对治疗泰国人群Lenke 5型AIS时合适的椎弓根螺钉直径和长度选择的理解。
