ISSN : 2663-2187

Comparative study of CT scan and dissection measurements of pedicle width, screw path length and screw path angle in thoracolumbar spines of cadavers

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Snigdha Mishra M.Sc, Mamatha H MD, Shyamasunder N. Bhat MS
» doi: 10.48047/AFJBS.6.12.2024.4805-4816

Abstract

Objective: Pedicle screw fixation is a method of choice for spinal instabilities. A detailed knowledge of anatomy of the pedicles is essential for preoperative planning. CT scan measurements form the main mode of assessing the morphometry of pedicles. Even with the preoperative measurements on CT scans, pedicle screws sometimes not match with the pedicle measurements during the surgery. This can lead to violation of the pedicles leading to breaches causing increased risk of vascular or neurological damage. The available studies focus mainly on anatomy of pedicles in Caucasian populations, with only a few studies that documentpedicle anatomy in Indian populations. The main objectives of this study were to measure the pedicle width, screw path length and screw path angle on axial section in CT scan and dissection in thoracolumbar spines of cadavers and to compare the findings of the CT scan measurements and the actual dissection measurements. Methods: The study was done on 10 formalin fixed cadavers. The cadavers were subjected to CT scan of their thoracolumbar spine. Pedicle width, screw path angle and screw path length were measured on the axial section for all the thoracic and lumbar vertebrae. Following this the cadaveric spine was sliced using band saw to obtain an axial section. The measurements of the pedicles were taken. Mean and standard deviations were obtained for all the measurements taken (CT scan and dissection). Result: The comparison study of the CT scan and dissection data for the thoracolumbar pedicles showed that bilateralpedicle widthswere measured higher on dissecting. The mean bilateral screw path lengths of thoracic vertebrae measured higher on the CT scanwhereas on the lumbar vertebrae, higher measurements were seen on dissecting. The Screw path angles of bilateral pedicles showed almost no difference in the thoracic vertebrae, but lumbar vertebrae measured higher on dissection measurements. Conclusion: The pedicle morphology measured on a CT scan and on dissection shows significant difference statistically. But, the differences don’t seem to result in a severe breach during the pedicle screw fixation. The differences fall into the Grade0 to grade 2 on the Gertzbein scale. Also the pedicle measurements in the Indian population needs documentation, as they measure lesser than the Caucasian counterparts.

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