Universität zu Köln

Westermann, Leonard, Spemes, Carolin, Eysel, Peer, Simons, Marvin, Scheyerer, Max J., Siewe, Jan and Baschera, Dominik ORCID: 0000-0002-9634-9922 (2018). Computer tomography-based morphometric analysis of the cervical spine pedicles C3-C7. Acta Neurochir., 160 (4). S. 863 - 872. WIEN: SPRINGER WIEN. ISSN 0942-0940

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Abstract

Our aim was to examine the specific dimensions of cervical pedicles in a large Caucasian cohort on high dissolving CT scans. A retrospective analysis of 100 cervical spine CT scans with a maximum slice thickness of 1 mm in axial, sagittal, and coronal reconstructions was performed. The pedicle axial length (PAL), inner and outer pedicle diameter (IPD/OPD), pedicle sagittal and transverse angle (PSA/PTA), pedicle height (PH), pedicle width (PW), and the cortical thickness (COT) at different margins were measured by two independent observers. A total of 1000 cervical pedicles (C3-C7) of 52 male (age 58 +/- 17.47 years, height 177.97 +/- 8.17 cm) and 48 female patients (age 57 +/- 19.07 years, height 165.50 +/- 7.44) were measured. Cortical thickness at the medial limitation of the pedicle was 1.77 +/- 0.43 and 0.90 +/- 0.36 mm at the lateral limitation (p < 0.001). The mean PAL ranged from 30.5 mm at C4 level to 35.3 mm at C6 level. PW and PAL were smaller in the female than in the male patients. The smallest values for PW were at C3 with 29.17% of males and 52.88% of females < 4.5 mm. The percentage of patients with PW < 4.5 mm decreased caudally with less than 10% of pedicles below C4 in male participants and below C6 in female participants. Mean PTA ranged from 34.6A degrees to 48.02A degrees peaking at C4 and C5 levels. No gender-specific difference was found for PTA and PSA (p >= 0.13). IPD and OPD were larger in males (p < 0.001), and body height correlated significantly with IPW (p <= 0.019) and OPW (p <= 0.003). The interrater reliability was very good for PW, PH, and IPD (0.84-0.86), good for OPD, PTA, and PSA (0.64-0.79), and moderate for PAL (0.54) and cortical thickness (0.44). Peculiarities of pedicle dimension of this central European cohort are comparable to morphometric studies in other ethnicities. Preoperative planning before cervical pedicle screw insertion on fine-cut CT scans demonstrates good interrater reliability for all important dimensions and angulations. More than half of female patients and almost a third of male patients had a PW of less than 4.5 mm at C3 level. Even though this percentage decreases caudally, pedicle screws might not be safe to insert in a noteworthy percentage of patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Westermann, Leonard UNSPECIFIED UNSPECIFIED UNSPECIFIED Spemes, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Simons, Marvin UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheyerer, Max J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Baschera, Dominik UNSPECIFIED orcid.org/0000-0002-9634-9922 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-191934
DOI:	10.1007/s00701-018-3481-4
Journal or Publication Title:	Acta Neurochir.
Volume:	160
Number:	4
Page Range:	S. 863 - 872
Date:	2018
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	0942-0940
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSPEDICULAR SCREW FIXATION; QUANTITATIVE 3-DIMENSIONAL ANATOMY; BIOMECHANICAL ANALYSIS; CLINICAL ARTICLE; PLACEMENT; VERTEBRAE; PERFORATION; INSERTION; ACCURACY; FEASIBILITY Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19193