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Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients

Received: 24 April 2022    Accepted: 7 May 2022    Published: 12 May 2022
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Abstract

Knowledge of the morphometric measurements of Filipino thoracic spine pedicles would help the surgeons in determining the proper size and increase accuracy of pedicle screws placement during surgery to avoid complications. This study aims to measure the outer diameter, chord length and transverse angulation of the thoracic spine pedicles (T1-T12). A retrospective analysis of patients ages 18-85 years who underwent CT scan of the thoracic spine from January to December 2019. A total of 65 patients were included in the study. Pedicle morphology was measured with the following: transverse outer pedicle diameter, pedicle chord length, and transverse pedicle angle. TOPD was narrowest at the level of T4 (4.2 ± 1.0mm) followed by T5 (4.6 ± 1.0mm) and the largest TOPD at the level of T12 (8.7 ± 2.1mm). The largest PCL was at the level T12 (47.7 ± 4.6mm) and the shortest was at T2 (35.6 ± 3.7mm). The mean TPA largest at the level of T1 (35.8 ± 6.1mm) and progressively decreasing and slight increase at the level of T12 (6.3 ± 3.5mm). Men have larger pedicles as compared with women. It is recommended to use 4.5mm pedicle screw however it should be used with extra caution especially at mid thoracic level and among female patients.

Published in International Journal of Neurosurgery (Volume 6, Issue 1)
DOI 10.11648/j.ijn.20220601.14
Page(s) 19-22
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Thoracic Pedicle, Pedicle Morphology, Pedicle Diameter, Pedicle Length, Pedicle Angle, Pedicle Screw

References
[1] Truumees, E. Thoracic And Lumbar Instrumentation: Anterior And Posterior. In: Garfin, SR, Eismont, FJ, Bell, GR, Fischgrund, JS, Bono, CM, Editors. Rothman-Simeone And Herkowitz’s The Spine. 7th Ed. Philadelphia: Elsevier, Inc.; 2018. P. 1187-1217.
[2] Knez D, Vrtovec T. Computerized Three-Dimensional Pedicle Morphometry from Computed Tomography Images of the Thoracic Spine. Image Analysis and Stereology. 2020; 39 (2): 101–9.
[3] Liau KM, Yusof MI, Abdullah MS, Abdullah S, Yusof AH. Computed Tomographic Morphometry of Thoracic Pedicles Safety Margin of Transpedicular Screw Fixation in Malaysian Malay Population. Vol. 31, Spine.
[4] Layeeque KM, Karambelkar RR, Shewale AD. Pedicle Dimensions of Thoracic Vertebrae in Maharashtrian Population. Journal of Evolution of Medical and Dental Sciences. 2014 Nov 25; 3 (65): 14146–53.
[5] Soh TLT, Kho KC, Lim ZK, Tandon AA, Kaliya-Perumal AK, Oh JYL. Morphological Parameters of the Thoracic Pedicle in an Asian Population: A Magnetic Resonance Imaging–Based Study of 3324 Pedicles. Global Spine Journal. 2021 May 1; 11 (4): 437–41.
[6] Nojiri K, Matsumoto M, Chiba K, Toyama Y. Morphometric Analysis of the Thoracic and Lumbar Spine in Japanese on the Use of Pedicle Screws. Surgical and Radiologic Anatomy. 2005 Apr; 27 (2): 123–8.
[7] Kim JH, Choi Gm, Chang IB, et al. Pedicular and Extrapedicular Morphometric Analysis In The Korean Population: Computed Tomographic Assessment Relevance To Pedicle And Extrapedicle Screw Fixation in the Thoracic Spine. Journal of Korean Neurosurgical Society. 2009 Sep; 46 (3): 181-188.
[8] Muteti E, Teaching M, Hospital R, ElBadawi M. A CT-Based Study of the Thoracic Spine Pedicle and Pedicle-Rib Unit Morphometry in a Kenyan Population. Vol. 13, East African Orthopaedic Journal EAOJ. 2019.
[9] Hackenberg L, Link T, Liljenqvist U. Axial and Tangential Fixation Strength of Pedicle Screws Versus Hooks in the Thoracic Spine in Relation to Bone Mineral Density. Spine (Phila Pa 1976). 2002; 27: 937-942.
[10] Suk SI, Kim WJ, Lee SM, Kim JH, Chung ER. Thoracic Pedicle Screw Fixation in Spinal Deformities: Are They Really Safe? Spine (Phila Pa 1976). 2001; 26: 2049-2057.
[11] Misenhimer GR, Peek RD, Wiltse LL, Rothman SL, Widell EH Jr. Anatomic Analysis of Pedicle Cortical and Cancellous Diameter as Related to Screw Size. Spine (Phila Pa 1976). 1989; 14: 367-372.
[12] Cahill P, Rinella AS, Ghanayem A, et al. P8. Thoracic Pedicle Expansion After Pedicle Screw Insertion in a Pediatric Cadaveric Spine: A Biomechanical Analysis. Spine J. 2004; 4 (5 Suppl): S93.
[13] Zhuang, Z, Chen, Y, et al. Thoracic Pedicle Morphometry in Different Body Height Population. A Three Dimensional Study Using Reformatted Computed Tomography. Spine: November 15, 2011 – Volume 36 – Issue 24 – p E1547-E1554. doi: 10.1097/BRS.0b013e318210f063.
[14] Shetty, A, Avadhani, R, et al. Thoracic Pedicle Morphometry Study on Cadaver and CT Scan with Its Clinical Applications. 2019; Original Research Article, 7 (1), 6089–6100. https://doi.org/10.16965/ijar.2018.414
[15] Pai, B. S., Gangadhara, Nirmala, S., Muralimohan, S., & Varsha, S. M. (2010). Morphometric analysis of the thoracic pedicle: An anatomico-radiological study. Neurology India, 58 (2), 253–258. https://doi.org/10.4103/0028-3886.63808
[16] Verma, V., Santoshi, J. A., Jain, V., Patel, M., Dwivedi, M., Nagar, M., Selvanayagam, R., & Pal, D. (2020). Thoracic Pedicle Morphometry of Dry Vertebral Columns in Relation to Trans-Pedicular Fixation: A Cross-Sectional Study From Central India. Cureus. https://doi.org/10.7759/cureus.8148
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  • APA Style

    Billy Francis Yu Hung, Paolo Antonio Florencio Castro. (2022). Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients. International Journal of Neurosurgery, 6(1), 19-22. https://doi.org/10.11648/j.ijn.20220601.14

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    ACS Style

    Billy Francis Yu Hung; Paolo Antonio Florencio Castro. Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients. Int. J. Neurosurg. 2022, 6(1), 19-22. doi: 10.11648/j.ijn.20220601.14

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    AMA Style

    Billy Francis Yu Hung, Paolo Antonio Florencio Castro. Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients. Int J Neurosurg. 2022;6(1):19-22. doi: 10.11648/j.ijn.20220601.14

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  • @article{10.11648/j.ijn.20220601.14,
      author = {Billy Francis Yu Hung and Paolo Antonio Florencio Castro},
      title = {Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients},
      journal = {International Journal of Neurosurgery},
      volume = {6},
      number = {1},
      pages = {19-22},
      doi = {10.11648/j.ijn.20220601.14},
      url = {https://doi.org/10.11648/j.ijn.20220601.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220601.14},
      abstract = {Knowledge of the morphometric measurements of Filipino thoracic spine pedicles would help the surgeons in determining the proper size and increase accuracy of pedicle screws placement during surgery to avoid complications. This study aims to measure the outer diameter, chord length and transverse angulation of the thoracic spine pedicles (T1-T12). A retrospective analysis of patients ages 18-85 years who underwent CT scan of the thoracic spine from January to December 2019. A total of 65 patients were included in the study. Pedicle morphology was measured with the following: transverse outer pedicle diameter, pedicle chord length, and transverse pedicle angle. TOPD was narrowest at the level of T4 (4.2 ± 1.0mm) followed by T5 (4.6 ± 1.0mm) and the largest TOPD at the level of T12 (8.7 ± 2.1mm). The largest PCL was at the level T12 (47.7 ± 4.6mm) and the shortest was at T2 (35.6 ± 3.7mm). The mean TPA largest at the level of T1 (35.8 ± 6.1mm) and progressively decreasing and slight increase at the level of T12 (6.3 ± 3.5mm). Men have larger pedicles as compared with women. It is recommended to use 4.5mm pedicle screw however it should be used with extra caution especially at mid thoracic level and among female patients.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Computed Tomographic Measurement of Thoracic Pedicle in Filipino Patients
    AU  - Billy Francis Yu Hung
    AU  - Paolo Antonio Florencio Castro
    Y1  - 2022/05/12
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijn.20220601.14
    DO  - 10.11648/j.ijn.20220601.14
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 19
    EP  - 22
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20220601.14
    AB  - Knowledge of the morphometric measurements of Filipino thoracic spine pedicles would help the surgeons in determining the proper size and increase accuracy of pedicle screws placement during surgery to avoid complications. This study aims to measure the outer diameter, chord length and transverse angulation of the thoracic spine pedicles (T1-T12). A retrospective analysis of patients ages 18-85 years who underwent CT scan of the thoracic spine from January to December 2019. A total of 65 patients were included in the study. Pedicle morphology was measured with the following: transverse outer pedicle diameter, pedicle chord length, and transverse pedicle angle. TOPD was narrowest at the level of T4 (4.2 ± 1.0mm) followed by T5 (4.6 ± 1.0mm) and the largest TOPD at the level of T12 (8.7 ± 2.1mm). The largest PCL was at the level T12 (47.7 ± 4.6mm) and the shortest was at T2 (35.6 ± 3.7mm). The mean TPA largest at the level of T1 (35.8 ± 6.1mm) and progressively decreasing and slight increase at the level of T12 (6.3 ± 3.5mm). Men have larger pedicles as compared with women. It is recommended to use 4.5mm pedicle screw however it should be used with extra caution especially at mid thoracic level and among female patients.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Department of Orthopaedics, East Avenue Medical Center, Quezon City, Philippines

  • Department of Orthopaedics, East Avenue Medical Center, Quezon City, Philippines

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