scholarly journals Computerized three-dimensional pedicle morphometry from computed tomography images of the thoracic spine

2020 ◽  
Author(s):  
Dejan Knez ◽  
Tomaž Vrtovec

Knowledge of pedicle morphometry is valuable for a safe and reliable pedicle screw placement. In this study, we performed and evaluated computerized pedicle morphometry measurements from preoperative computed tomography (CT) images of the thoracic spine from 26 subjects. Manual measurements of the pedicle width, height and chord length were obtained for 540 thoracic pedicles in selected cross sections of orthogonal and oblique multiplanar reconstructions (MPRs). Computerized measurements of the pedicle width, height, length, chord length, transverse angulation, sagittal angulation and cross-sectional area were obtained for the same pedicles by an automated method that is based on parametric modeling of vertebral structures in three dimensions (3D). Statistical analysis revealed that manual measurements from orthogonal MPRs were significantly different (p ≤ 0.0011) when compared to those from oblique MPRs and computerized measurement in 3D, with the respective mean absolute difference (MAD) ± standard deviation (SD) of 0.77 ± 0.56 mm and 0.74 ± 0.57 mm for the pedicle width, and 1.31 ± 1.08 mm and 1.45 ± 1.10 mm for the pedicle height. No statistically significant differences (p ≥ 0.12) were observed between manual measurements from oblique MPRs and computerized measurements in 3D, with MAD ± SD of 0.44 ± 0.35 mm, 0.56 ± 0.52 mm and 1.72 ± 1.29 mm for the pedicle width, height and chord length, respectively. The advantage of computerized measurements is that they allow the extraction of additional pedicle morphometric parameters, which are important for preoperative planning of pedicle screw placement, or can be used for population and demographic studies using larger pedicle databases.

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
S. Harrison Farber ◽  
Jakub Godzik ◽  
Randall J. Hlubek ◽  
James J. Zhou ◽  
Corey T. Walker ◽  
...  

2009 ◽  
Vol 8 (1) ◽  
pp. 80-83
Author(s):  
Adebukoa Onibokun ◽  
Simona Bistazzoni ◽  
Marco Sassi ◽  
Larry T. Khoo

OBJECTIVE: more detailed anatomical knowledge of the C2 pedicle is required to optimize and minimize the risk of screw placement. The aim of this study was to evaluate the linear and angular dimensions of the true C2 pedicle using axial CT. METHODS: ninety three patients (47 males, 46 females mean age 48 years) who had cervical spinal CT imaging performed were evaluated for this study. Axial images of the C2 pedicle were selected and the following pedicle parameters were determined: pedicle width (PW, the mediolateral diameter of the pedicle isthmus, perpendicular to the pedicle axis) and pedicle transverse angle (PTA, that is, the angle between the pedicle axis and the midline of the vertebral body). RESULTS: the overall mean pedicle width was 5.8 1.2mm. The mean pedicle width in males (6.01.3mm) was greater than that in the female subjects (5.6 1.1mm). This difference was not found to be statistically significant (p=.6790). The overall mean pedicle transverse angle was 43.93.9 degrees. The mean PTA in males was 43.23.8 degrees, while that in females was 44.73.7 degrees. CONCLUSION: preoperative planning is absolutely mandatory, particularly in determining not only screw trajectory, but in analyzing individual patient anatomy and reception to a C2 pedicle screw.


2021 ◽  
Vol 12 ◽  
pp. 518
Author(s):  
Mohamed M. Arnaout ◽  
Magdy O. ElSheikh ◽  
Mansour A. Makia

Background: Transpedicular screws are extensively utilized in lumbar spine surgery. The placement of these screws is typically guided by anatomical landmarks and intraoperative fluoroscopy. Here, we utilized 2-week postoperative computed tomography (CT) studies to confirm the accuracy/inaccuracy of lumbar pedicle screw placement in 145 patients and correlated these findings with clinical outcomes. Methods: Over 6 months, we prospectively evaluated the location of 612 pedicle screws placed in 145 patients undergoing instrumented lumbar fusions addressing diverse pathology with instability. Routine anteroposterior and lateral plain radiographs were obtained 48 h after the surgery, while CT scans were obtained at 2 postoperative weeks (i.e., ideally these should have been performed intraoperatively or within 24–48 h of surgery). Results: Of the 612 screws, minor misplacement of screws (≤2 mm) was seen in 104 patients, moderate misplacement in 34 patients (2–4 mm), and severe misplacement in 7 patients (>4 mm). Notably, all the latter 7 (4.8% of the 145) patients required repeated operative intervention. Conclusion: Transpedicular screw insertion in the lumbar spine carries the risks of pedicle medial/lateral violation that is best confirmed on CT rather than X-rays/fluoroscopy alone. Here, we additional found 7 patients (4.8%) who with severe medial/lateral pedicle breach who warranting repeated operative intervention. In the future, CT studies should be performed intraoperatively or within 24–48 h of surgery to confirm the location of pedicle screws and rule in our out medial or lateral pedicle breaches.


2006 ◽  
Vol 19 (8) ◽  
pp. 547-553 ◽  
Author(s):  
Theodore J. Choma ◽  
Francis Denis ◽  
John E. Lonstein ◽  
Joseph H. Perra ◽  
James D. Schwender ◽  
...  

Spine ◽  
1998 ◽  
Vol 23 (9) ◽  
pp. 1065-1068 ◽  
Author(s):  
Rongming Xu ◽  
Nabil A. Ebraheim ◽  
Yianjia Ou ◽  
Richard A. Yeasting

Spine ◽  
2003 ◽  
Vol 28 (22) ◽  
pp. 2527-2530 ◽  
Author(s):  
Ganesh Rao ◽  
Darrel S. Brodke ◽  
Matthew Rondina ◽  
Kent Bacchus ◽  
Andrew T. Dailey

Spine ◽  
2014 ◽  
Vol 39 (18) ◽  
pp. E1058-E1065 ◽  
Author(s):  
Pankaj Kumar Singh ◽  
Kanwaljeet Garg ◽  
Duttaraj Sawarkar ◽  
Deepak Agarwal ◽  
Guru Dutta Satyarthee ◽  
...  

Spine ◽  
2012 ◽  
Vol 37 (3) ◽  
pp. E188-E194 ◽  
Author(s):  
A. Noelle Larson ◽  
Edward R. G. Santos ◽  
David W. Polly ◽  
Charles G. T. Ledonio ◽  
Jonathan N. Sembrano ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document