Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine

Pedicle screws are widely used in spinal surgeries, but it remains technically demanding to place. There are numerous studies on the anatomy of pedicle; however, there is very little insight on the relationship between the pedicle and the spinous process, which is an important part of the spinal pos...

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Autores principales: Cui, Xingang, Wang, Guodong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457850/
https://www.ncbi.nlm.nih.gov/pubmed/28538370
http://dx.doi.org/10.1097/MD.0000000000006732
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author Cui, Xingang
Wang, Guodong
author_facet Cui, Xingang
Wang, Guodong
author_sort Cui, Xingang
collection PubMed
description Pedicle screws are widely used in spinal surgeries, but it remains technically demanding to place. There are numerous studies on the anatomy of pedicle; however, there is very little insight on the relationship between the pedicle and the spinous process, which is an important part of the spinal posterior column. The aim of the study was to investigate the radiographic anatomical relationship between spinous processes and pedicles in the thoracolumbar and lumbar spine, in order to reveal a novel entrance point for pedicle screw insertion. Sixty candidates were enrolled in this study; cases were excluded with degenerative disorders and other disorders as osteoporosis, deformity, and tumor. Radiographs and computer tomography scans between T10 and L5 were obtained on each case. The distance was measured that between the superior margin of spinous process root and the superior border, the inferior border and the axis of pedicle. In laboratory, 5 fresh cadavers were used to imitate the pedicle screw insertion. The basic reference point was supposed as the intersection between the horizontal line of superior margin of spinous process root and the central vertical line of the superior facet. For T10 to T12, the pedicle axis was 5 mm beyond the reference point. For L1 to L4, the pedicle axis was at the reference point. At L5, the pedicle axis was 5 mm beneath the reference point. In laboratory, 80 screws were all inserted into pedicles successfully according to the newly referred entrance point. The study reveals the radiographic anatomical relationship between the pedicle and the spinous process. The pedicle axis is around the horizontal line of the superior margin of spinous process root. It provides a new anatomic mark of pedicle screw entrance point.
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spelling pubmed-54578502017-06-09 Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine Cui, Xingang Wang, Guodong Medicine (Baltimore) 6800 Pedicle screws are widely used in spinal surgeries, but it remains technically demanding to place. There are numerous studies on the anatomy of pedicle; however, there is very little insight on the relationship between the pedicle and the spinous process, which is an important part of the spinal posterior column. The aim of the study was to investigate the radiographic anatomical relationship between spinous processes and pedicles in the thoracolumbar and lumbar spine, in order to reveal a novel entrance point for pedicle screw insertion. Sixty candidates were enrolled in this study; cases were excluded with degenerative disorders and other disorders as osteoporosis, deformity, and tumor. Radiographs and computer tomography scans between T10 and L5 were obtained on each case. The distance was measured that between the superior margin of spinous process root and the superior border, the inferior border and the axis of pedicle. In laboratory, 5 fresh cadavers were used to imitate the pedicle screw insertion. The basic reference point was supposed as the intersection between the horizontal line of superior margin of spinous process root and the central vertical line of the superior facet. For T10 to T12, the pedicle axis was 5 mm beyond the reference point. For L1 to L4, the pedicle axis was at the reference point. At L5, the pedicle axis was 5 mm beneath the reference point. In laboratory, 80 screws were all inserted into pedicles successfully according to the newly referred entrance point. The study reveals the radiographic anatomical relationship between the pedicle and the spinous process. The pedicle axis is around the horizontal line of the superior margin of spinous process root. It provides a new anatomic mark of pedicle screw entrance point. Wolters Kluwer Health 2017-05-26 /pmc/articles/PMC5457850/ /pubmed/28538370 http://dx.doi.org/10.1097/MD.0000000000006732 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 6800
Cui, Xingang
Wang, Guodong
Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title_full Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title_fullStr Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title_full_unstemmed Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title_short Radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
title_sort radiographic anatomical relationship between spinous process and pedicle in thoracolumbar and lumbar spine
topic 6800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457850/
https://www.ncbi.nlm.nih.gov/pubmed/28538370
http://dx.doi.org/10.1097/MD.0000000000006732
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