A novel radiographic analysis system for subaxial cervical spine pedicle screw placement.

Humans Pedicle Screws Cervical Vertebrae / diagnostic imaging Spinal Fusion / methods Tomography, X-Ray Computed
Accurate CT scan Cervical spine Pedicle screw Placement

Journal

Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112

Informations de publication

Date de publication:
08 Aug 2023
Historique:
received: 06 03 2023
accepted: 10 07 2023
medline: 10 8 2023
pubmed: 9 8 2023
entrez: 8 8 2023
Statut: epublish

Résumé

Precise pedicle screw placement of the subaxial cervical spine is difficult. Not every hospital is equipped with a guidance system that can provide effective help. Computed tomography (CT) scanning is almost a routine preoperative examination for cervical spine surgery in all hospitals. Appropriate measurement and analysis of the CT images could assist optimal cervical pedicle screw placement. The purpose of this study is to propose a new and universal method using computed tomography (CT) morphological parameters analysis to assist optimal cervical pedicle screw placement from C3 to C7. A localization system with six parameters was designed based on preoperative CT reconstruction to guide subaxial cervical spine pedicle screw placement. The six parameters were distance from the starting point to the midline [D1], distance from the starting point to the lower edge of the inferior articular process [D2], transverse section angle [TSA], sagittal section angle [SSA], pedicle width [PW], and pedicle height [PH]. The six parameters were analyzed in 53 participants. Combining D1 and D2 could localize the entrance of the pedicle screw, and we concluded that D1 and TSA and D2 and SSA could be a new standard for determination of the transverse and sagittal orientation of the pedicle screw. The six parameters were closely related to the patient's gender, height, and weight. PH and PW were linearly correlated and could guide selection of the appropriate pedicle screw. SSA was an independent parameter of the relevant vertebral body, and changes in SSA had nothing to do with the curvature or posture of the cervical spine. Understanding and applying the six-parameter localization system are essential for achieving accurate and optimal pedicle screw placement in subaxial cervical spine, regardless of cervical sagittal alignment.

Sections du résumé

BACKGROUND BACKGROUND
Precise pedicle screw placement of the subaxial cervical spine is difficult. Not every hospital is equipped with a guidance system that can provide effective help. Computed tomography (CT) scanning is almost a routine preoperative examination for cervical spine surgery in all hospitals. Appropriate measurement and analysis of the CT images could assist optimal cervical pedicle screw placement. The purpose of this study is to propose a new and universal method using computed tomography (CT) morphological parameters analysis to assist optimal cervical pedicle screw placement from C3 to C7.
METHODS METHODS
A localization system with six parameters was designed based on preoperative CT reconstruction to guide subaxial cervical spine pedicle screw placement. The six parameters were distance from the starting point to the midline [D1], distance from the starting point to the lower edge of the inferior articular process [D2], transverse section angle [TSA], sagittal section angle [SSA], pedicle width [PW], and pedicle height [PH]. The six parameters were analyzed in 53 participants.
RESULTS RESULTS
Combining D1 and D2 could localize the entrance of the pedicle screw, and we concluded that D1 and TSA and D2 and SSA could be a new standard for determination of the transverse and sagittal orientation of the pedicle screw. The six parameters were closely related to the patient's gender, height, and weight. PH and PW were linearly correlated and could guide selection of the appropriate pedicle screw. SSA was an independent parameter of the relevant vertebral body, and changes in SSA had nothing to do with the curvature or posture of the cervical spine.
CONCLUSIONS CONCLUSIONS
Understanding and applying the six-parameter localization system are essential for achieving accurate and optimal pedicle screw placement in subaxial cervical spine, regardless of cervical sagittal alignment.

Identifiants

DOI: 10.1186/s13018-023-03999-9 PMID: 37553693 PMC: PMC10408217
pubmed: 37553693
doi: 10.1186/s13018-023-03999-9
pii: 10.1186/s13018-023-03999-9
pmc: PMC10408217
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

581

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Baozhi Ding (B)

Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, People's Republic of China.
Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.

Tangjun Zhou (T)

Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, People's Republic of China.
Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.

Hui Ma (H)

Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, People's Republic of China. sh9_spine@163.com.
Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China. sh9_spine@163.com.

Jie Zhao (J)

Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, People's Republic of China. zj1868@sjtu.edu.cn.
Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China. zj1868@sjtu.edu.cn.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A novel radiographic analysis system for...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Matériels de fixation chirurgicale › Appareils de fixation orthopédique › Fixateurs internes › Vis orthopédiques › Vis pédiculaires › A novel radiographic analysis system for...
questionsmedicales.fr › Appareil locomoteur › Squelette › Rachis › Vertèbres cervicales › A novel radiographic analysis system for...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Arthrodèse › Arthrodèse vertébrale › A novel radiographic analysis system for...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Tomographie à rayons X › Tomodensitométrie › A novel radiographic analysis system for...