Abstract
Purpose
The aims of this study were to review published data on pedicle dimensions and bony spinal canal diameters calculated from CT examinations of the cervical spine through the English-language literature and analyze these data for ethnic disparities and similarities.
Materials and methods
The authors reviewed the literature on “pedicle” and “spinal canal” by conducting a bibliographic search using PubMed, Ovid MEDLINE, and Science Direct from January 1985 to December 2010. After evaluating all of the selected abstracts, we ultimately selected 19 studies involving living subjects: 12 studies on pedicle dimensions and 7 on spinal canal diameters. The four parameters, pedicle width (PW), pedicle transverse angle (PTA), anterior-posterior diameter of the spinal canal (APD), and transverse diameter of the spinal canal (TD), were analyzed at the relevant levels from C3 to C7. In addition, the values for pedicle dimensions and spinal canal diameters in the European/American populations were compared using the data from Asian populations as a baseline.
Results
The smallest mean PW was found at C4 in the male (5.1 mm) and female populations (4.1 mm); the largest mean PW was found at C7 in both male (7.7 mm) and female populations (7 mm). The PW in males was greater than in females at the majority of levels. The smallest mean PTA was found at C7 in both male (33.4°) and female populations (33°); the largest mean PTA was found at C4 in both male (53.2°) and female populations (52.1°). The overall PW, PTA, APD, and TD ratio of European/American to Asian populations was 91.4–98.8, 99.6–106.2, 110.7–122, and 100–108.3 %, respectively.
Conclusion
Although our cervical spine CT data were suggestive of possible ethnic differences in spinal canal morphology, our analysis failed to identify significant ethnic disparity in pedicle dimensions despite potential differences in physique between populations.
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References
Abuzayed B, Tutunculer B, Kucukyuruk B, Tuzgen S (2010) Anatomic basis of anterior and posterior instrumentation of the spine: morphometric study. Surg Radiol Anat 32:75–85
Chazono M, Soshi S, Inoue T, Kida Y, Ushiku C (2006) Anatomical considerations for cervical pedicle screw insertion: the use of multiplanar computerized tomography reconstruction measurements. J Neurosurg Spine 4:472–477
Debois V, Herz R, Berghmans D, Hermans B, Herregodts P (1999) Soft cervical disc herniation. Spine 24:1996–2002
Hacker AG, Molley S, Bernard J (2008) The contralateral lamina: a reliable guide in subaxial, cervical pedicle screw placement. Eur Spine J 17:1457–1461
Inoue H, Ohmori K, Takatsu Y, Teramoto T, Ishida Y, Suzuki K (1996) Morphological analysis of the cervical spinal canal, dural tube and spinal cord in normal individuals using CT myelography. Neuroradiology 38:148–151
Koller H, Hempfing A, Acosta F, Fox M, Scheiter A, Tauber M, Holz U, Resch H, Hitzl W (2008) Cervical anterior transpedicular screw fixation. Part 1: Study on morphological feasibility, indications, and technical prerequisites. Eur Spine J 17:523–528
Matsuura P, Waters RL, Adkins RH, Rothman S, Gurbani N, Sie I (1989) Comparison of computerized tomography parameters of the cervical spine in normal control subjects and spinal cord-injured patients. J Bone Joint Surg Am 71:183–188
Miyazaki M, Takita C, Yoshiiwa T, Itonaga I, Tsumura H (2010) Morphological analysis of the cervical pedicles, lateral mass, and laminae in developmental canal stenosis. Spine 35:E1381–E1385
Onibokun A, Khoo LT, Bistazzoni S, Chen NF, Sassi M (2009) Anatomical considerations for cervical pedicle screw insertion: the use of multiplanar computed tomography measurements in 122 consecutive clinical cases. Spine J 9:729–734
Rao RD, Marawar SV, Stemper BD, Yoganandan N, Shender BS (2008) Computerized tomographic morphometric analysis of subaxial cervical spine pedicles in young asymptomatic volunteers. J Bone Joint Surg Am 90:1914–1921
Rezcallah AT, Xu R, Ebraheim NA, Jackson T (2001) Axial computed tomography of the pedicle in the lower cervical spine. Am J Orthop 30:59–61
Ruofu Z, Huilin Y, Xiaoyun H, Xishun H, Tiansi T, Liang C, Xigong L (2008) CT evaluation of cervical pedicle in a Chinese population for surgical application of transpedicular screw placement. Surg Radiol Anat 30:389–396
Sakamoto T, Neo M, Nakamura T (2004) Transpedicular screw placement evaluated by axial computed tomography of the cervical pedicle. Spine 29:2510–2514
Stanley JH, Schabel SI, Frey GD, Hungerford GD (1986) Quantitative analysis of the cervical spinal canal by computed tomography. Neuroradiology 28:139–143
Tomashino A, Parikh K, Koller H, Zink W, Tsiouris J, Steinberger J, Hartl R (2010) The vertebral artery and the cervical pedicle: morphometric analysis of a critical neighborhood. J Neurosurg Spine 13:52–60
Yusof MI, Ming LK, Abdullah MS, Yusof AH (2006) Computerized tomographic measurement of the cervical pedicles diameter in a Malaysian population and the feasibility for transpedicular fixation. Spine 31:E221–E224
Yl Zeng, Wang W (1988) CT measurement of the normal cervical and lumbar spinal canal in Chinese. Chin Med J 101:898–900
Panjabi MM, Duranceau J, Goel V, Oxland T, Tanaka K (1991) Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine 16:861–869
Okuyama K, Sato K, Abe E, Onuma S, Ishikawa N (1994) Vertebral pedicle diameter as determined by computed tomography: inaccuracies observed by direct measurement of cadaveric lumbar spine. Skeletal Radiol 23:551–553
Tan SH, Teo EC, Chua HC (2004) Quantitative three-dimensional anatomy of cervical, thoracic, and lumbar vertebrae of Chinese Singaporeans. Eur Spine J 13:137–146
Ogden JA, Ganey TM. Developmental and maturation of the axial skeleton. In: Weinstein S (ed) The pediatric spine: principles and practice. New York: Raven Press 1993:pp3-69
Vara CS, Thompson GH (2006) A cadaveric examination of pediatric cervical pedicle morphology. Spine 31:1107–1112
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Chazono, M., Tanaka, T., Kumagae, Y. et al. Ethnic differences in pedicle and bony spinal canal dimensions calculated from computed tomography of the cervical spine: a review of the English-language literature. Eur Spine J 21, 1451–1458 (2012). https://doi.org/10.1007/s00586-012-2295-y
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DOI: https://doi.org/10.1007/s00586-012-2295-y