Transpedicular screw fixation (TPSF) of the cervical spine provides excellent biomechanical stability


Osama Al-Saeed

Kuwait University, Kuwait

: J Diagn Tech Biomed Anal

Abstract


Introduction: Transpedicular screw fixation (TPSF) of the cervical spine provides excellent biomechanical stability; however, this technique requires a good understanding of the anatomy of the pedicles in order to avoid damaging nearby neurovascular structures. We aim to evaluate the morphometry of subaxial cervical spine pedicles among Arabs. Methods: This cross-sectional study involved a retrospective review of computed tomography (CT) scans of normal cervical spines of 99 Arab adults. A total of 990 pedicles (198 pedicles at each vertebral level; including right and left pedicles) were evaluated. Ten morphometric measurements were obtained. Data were analyzed using a p-value of ≤0.05 as the cut-off level of statistical significance. Results: Our sample included 63 (63.6%) males and 36 (36.4%) females, with a mean age of 35.5±16.5 years. The morphometric parameters of C3 to C7 cervical spine pedicles were larger in men compared to women. The outer pedicle width (OPW) was <4.5 mm in more than 25% of all subjects at C3 to C6 vertebrae. Among females, this was seen in more than one-third at C3 to C6 vertebrae. Statistically significant differences in the OPW between males and females were noted at C3 (p=0.032) and C6 (p=0.004). Conclusions: For the majority of our subjects, inserting screws in the pedicles of C3 to C7 vertebrae is feasible. In order to avoid serious intraoperative complications, the spine surgeon should properly assess the morphometry of the pedicles preoperatively for Arab patients undergoing TPSF surgery at the level of the cervical spine.

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E-Mail:

osamas@hsc.edu.kw

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