Ramachandran Karthik, Naik Ashish Shankar, Thippeswamy Pushpa Bhari, Shetty Ajoy Prasad, Kanna Rishi Mugesh, Rajasekaran Shanmuganathan
Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India.
Department of Radiology, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, India.
Spine Deform. 2025 Jun 19. doi: 10.1007/s43390-025-01131-x.
The purpose of the study is to assess the MRI predictability of pedicle dimensions in AIS patients with curve magnitude more than 50° and to determine the influence of curve magnitude and vertebral rotation on MRI predictability.
The study included a comparative analysis of preoperative MRI (pMRI), and intraoperative CT (iCT) scan images of surgically corrected AIS patients with a curve magnitude of more than 50°. Bilateral T2-L4 pedicle levels were evaluated to measure the chord length and isthmic diameter in pMRI and iCT axial cuts. Vertebral rotation was assessed using the Nash and Moe method. Patients were categorised based on structural curve magnitude into group 1 (50°-70°), group 2 (71°-90°), and group 3 (> 90°).
A total of 1860 pedicles in 62 patients were analysed. Comparison between iCT and pMRI measurements showed excellent reliability (ICC > 0.90) for pedicle diameter at all levels except the apical levels. Comparison based on curve magnitude revealed at the apical levels showed good correlation (ICC = 0.87) in Group 1, moderate correlation (ICC = 0.75) in Group 2 and poor reliability (ICC = 0.37) in Group 3. However, the pedicle length showed excellent reliability (ICC = 0.92) across all three groups. Moreover, MRI reliability for predicting vertebral dimensions decreased as the degree of rotation increased.
Both the curve magnitude and vertebral rotation significantly impact the MRI prediction of the pedicle dimensions, with predictability decreasing as the curve magnitude and vertebral rotation increase.
本研究旨在评估曲线幅度大于50°的青少年特发性脊柱侧弯（AIS）患者椎弓根尺寸的MRI预测性，并确定曲线幅度和椎体旋转对MRI预测性的影响。
本研究对手术矫正的曲线幅度大于50°的AIS患者的术前MRI（pMRI）和术中CT（iCT）扫描图像进行了对比分析。在pMRI和iCT轴位图像上评估双侧T2-L4椎弓根水平，以测量弦长和峡部直径。使用Nash和Moe方法评估椎体旋转情况。根据结构曲线幅度将患者分为1组（50°-70°）、2组（71°-90°）和3组（>90°）。
共分析了62例患者的1860个椎弓根。iCT和pMRI测量结果的比较显示，除顶椎水平外，所有水平的椎弓根直径均具有出色的可靠性（ICC>0.90）。基于曲线幅度的顶椎水平比较显示，1组具有良好的相关性（ICC=0.87），2组具有中等相关性（ICC=0.75），3组可靠性较差（ICC=0.37）。然而，椎弓根长度在所有三组中均显示出出色的可靠性（ICC=0.92）。此外，随着旋转程度的增加，MRI预测椎体尺寸的可靠性降低。
曲线幅度和椎体旋转均对椎弓根尺寸的MRI预测有显著影响，且随着曲线幅度和椎体旋转的增加，预测性降低。
