Yıl: 2021 Cilt: 32 Sayı: 1 Sayfa Aralığı: 14 - 19 Metin Dili: İngilizce DOI: 10.4274/jtss.galenos.2021.36 İndeks Tarihi: 30-06-2021

MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION

Öz:
Objective: Transpedicular screw fixation for the subaxial cervical spine is considered to be more stable than other posterior fixation techniques despite its technical challenges. Thorough understanding of cervical pedicle anatomy and morphometric parameters is essential to avoid neurovascular injury during screw placement. To evaluate subaxial cervical spine pedicle dimensions, screw starting points, and screw trajectories to provide data that might be representative of the entire Anatolian peninsula. Materials and Methods: This retrospective study included 200 patients (2000 cervical pedicles). The distance from the junction of the lamina and spinous process to the entry point (DEP), pedicle width (PW), pedicle maximum axis length (PAL), pedicle transverse angle (PTA) in the axial plane, and pedicle height (PH) in the sagittal plane were measured from C3 to C7 on computed tomography (CT) by two blinded observers. Results: The mean values for DEP, PW, PAL, PTA and PHA ranged between 22.92 mm-23.75 mm, 4.99 mm-6.26 mm, 28.24 mm-36.01 mm, 33.52°- 34.60° and 6.36 mm-7.03 mm, respectively. The PW significantly increased in the rostrocaudal direction. The PAL was significantly different between the right and left sides at C3 in male patients. The PTA was significantly different between the right and left sides at C3 in female patients. The PH was greater than the PW at all levels on both sides. Conclusion: Although surgical planning should be carried out on a case-by-case basis, the findings of the present study might be helpful for Turkish spine surgeons in decision-making for the accurate placement of cervical pedicle screws.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Kwon BK, Vaccaro AR, Grauer JN, Beiner JM. The use of rigid internal fixation in the surgical management of cervical spondylosis. Neurosurgery. 2007;60:118-29.
  • 2. Coe JD, Vaccaro AR, Dailey AT, Skolasky RL Jr, Sasso RC, Ludwig SC, et al. Lateral mass screw fixation in the cervical spine: A systematic literature review. J Bone Joint Surg Am. 2013;95:2136-43.
  • 3. Abumi K, Itoh H, Taneichi H, Kaneda K. Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report. J Spinal Disord. 1994;7:19-28.
  • 4. Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique. J Spinal Disord. 1994;7:222-9.
  • 5. Jones EL, Heller JG, Silcox DH, Hutton WC. Cervical pedicle screws versus lateral mass screws. Anatomic feasibility and biomechanical comparison. Spine (Phila Pa 1976).1997;22:977-82.
  • 6. Liu Y, Zhang B, Dai M, Xiong HC, Gao S, Li BH, et al. Anatomic study of individualized and improved pedicle screw implantation in the lower cervical spine. Int Surg. 2015;100:328-33.
  • 7. Uğur HC, Attar A, Uz A, Tekdemir I, Egemen N, Cağlar S, et al. Surgical anatomic evaluation of the cervical pedicle and adjacent neural structures. Neurosurgery. 2000;47:1162-9.
  • 8. Kayalioglu G, Erturk M, Varol T, Cezayirli E. Morphometry of the cervical vertebral pedicles as a guide for transpedicular screw fixation. Neurol Med Chir (Tokyo). 2007;47:102-8.
  • 9. Abuzayed B, Tutunculer B, Kucukyuruk B, Tuzgen S. Anatomic basis of anterior and posterior instrumentation of the spine: morphometric study. Surg Radiol Anat. 2010;32:75-85.
  • 10. Gupta R, Kapoor K, Sharma A, Kochhar S, Garg R. Morphometry of typical cervical vertebrae on dry bones and CT scan and its implications in transpedicular screw placement surgery. Surg Radiol Anat. 2013;35:181-9.
  • 11. Simşek S, Uz A, Er U, Apaydın N. Quantitative evaluation of the anatomical parameters for subaxial cervical spondylectomy: an anatomical study. J Neurosurg Spine. 2013;18:568-74.
  • 12. Saluja S, Patil S, Vasudeva N. Morphometric analysis of sub-axial cervical vertebrae and its surgical implications. J Clin Diagn Res. 2015;9:1-4.
  • 13. Herrero CF, Luis do Nascimento A, Maranho DAC, Ferreira-Filho NM, Nogueira CP, Nogueira-Barbosa MH, et al. Cervical pedicle morphometry in a Latin American population: a Brazilian study. Medicine (Baltimore). 2016;95:e3947.
  • 14. Westermann L, Spemes C, Eysel P, Simons M, Scheyerer MJ, Siewe J, et al. Computer tomography-based morphometric analysis of the cervical spine pedicles C3-C7. Acta Neurochir (Wien). 2018;160:863-71.
  • 15. Rao RD, Marawar SV, Stemper BD, Yoganandan N, Shender BS. Computerized tomographic morphometric analysis of subaxial cervical spine pedicles in young asymptomatic volunteers. J Bone Joint Surg Am. 2008;90:1914-21.
  • 16. Ludwig SC, Kramer DL, Balderston RA, Vaccaro AR, Foley KF, Albert TJ. Placement of pedicle screws in the human cadaveric cervical spine: comparative accuracy of three techniques. Spine (Phila Pa 1976). 2000;25:1655-67.
  • 17. Lee DH, Lee SW, Kang SJ, Hwang CJ, Kim NH, Bae JY, et al. Optimal entry points and trajectories for cervical pedicle screw placement into subaxial cervical vertebrae. Eur Spine J. 2011;20:905-11.
  • 18. Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K. Cervical human vertebrae: quantitative three-dimensional anatomy of the middle and lower regions. Spine (Phila Pa 1976). 1991;16:861-9.
  • 19. Göç İstatistikleri. Türkiye İstatistik Kurumu [Internet]. http://www.tuik.gov.tr/PreTablo.do?alt_id=1067. Accessed Jul 09, 2019.
APA Sayin M, Cingöz İ, BAHADIR S, Ayhan S, temiz c (2021). MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. , 14 - 19. 10.4274/jtss.galenos.2021.36
Chicago Sayin Murat,Cingöz İlker Deniz,BAHADIR Sinan,Ayhan Selim,temiz cüneyt MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. (2021): 14 - 19. 10.4274/jtss.galenos.2021.36
MLA Sayin Murat,Cingöz İlker Deniz,BAHADIR Sinan,Ayhan Selim,temiz cüneyt MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. , 2021, ss.14 - 19. 10.4274/jtss.galenos.2021.36
AMA Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. . 2021; 14 - 19. 10.4274/jtss.galenos.2021.36
Vancouver Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. . 2021; 14 - 19. 10.4274/jtss.galenos.2021.36
IEEE Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c "MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION." , ss.14 - 19, 2021. 10.4274/jtss.galenos.2021.36
ISNAD Sayin, Murat vd. "MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION". (2021), 14-19. https://doi.org/10.4274/jtss.galenos.2021.36
APA Sayin M, Cingöz İ, BAHADIR S, Ayhan S, temiz c (2021). MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. Journal of Turkish Spinal Surgery, 32(1), 14 - 19. 10.4274/jtss.galenos.2021.36
Chicago Sayin Murat,Cingöz İlker Deniz,BAHADIR Sinan,Ayhan Selim,temiz cüneyt MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. Journal of Turkish Spinal Surgery 32, no.1 (2021): 14 - 19. 10.4274/jtss.galenos.2021.36
MLA Sayin Murat,Cingöz İlker Deniz,BAHADIR Sinan,Ayhan Selim,temiz cüneyt MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. Journal of Turkish Spinal Surgery, vol.32, no.1, 2021, ss.14 - 19. 10.4274/jtss.galenos.2021.36
AMA Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. Journal of Turkish Spinal Surgery. 2021; 32(1): 14 - 19. 10.4274/jtss.galenos.2021.36
Vancouver Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION. Journal of Turkish Spinal Surgery. 2021; 32(1): 14 - 19. 10.4274/jtss.galenos.2021.36
IEEE Sayin M,Cingöz İ,BAHADIR S,Ayhan S,temiz c "MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION." Journal of Turkish Spinal Surgery, 32, ss.14 - 19, 2021. 10.4274/jtss.galenos.2021.36
ISNAD Sayin, Murat vd. "MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION". Journal of Turkish Spinal Surgery 32/1 (2021), 14-19. https://doi.org/10.4274/jtss.galenos.2021.36