Determination of Variation in Dimensions of Lumbar Vertebral Pedicles among Indian Adult Population
Authors/Creators
- 1. Professor and Head, Department of Anatomy, Pacific Institute of Medical Sciences, Umarda, Udaipur
- 2. Professor and Head, Department of Anatomy, Geetanjali Medical College and Hospital, Udaipur, Rajasthan
- 3. Assistant Professor, Department of Anatomy, Pacific Institute of Medical Sciences Umarda, Udaipur
- 4. Assistant Professor, Department of Anatomy, Pacific Institute of Medical Sciences, Umarda, Udaipur
Description
Introduction: An operating surgeon can carry out these treatments more accurately and safely if they are aware of slight anatomical heterogeneity. Prior to implant implantation, general orthopedic surgery guidelines encourage templating with precise measurements. It is known that there is a significant discrepancy between both the historically recorded diameter of the outer cortical and the effective cancellous diameter, suggesting that a safe screw selection might not always be possible with the use of traditional methods. It is strongly believed by the surgeon community that appropriate morphometric information on the lumbar pedicles is essential to undertake these treatments in a risk-free setting. Aims and Objectives: To determine and analyze the dimensions of lumbar vertebral pedicles in adult Indian population. Methods: This is a prospective and observational study conducted on 35 specimens of lumbar vertebrae. The study considered 35 dry, fully ossified, healthy lumbar vertebral pairs from the Department of Anatomy were used in the investigation. All vertebrae were divided into typical (L1 to L4) and atypical categories for the study (L5). The specimens were determined for variation in their dimensions and required analysis were carried out for proper analysis. Results: Pedicles in normal vertebrae (L1 to L4) ranged in length and height from 8.86 millimetres to 10 millimetres and 13.12 millimetres to 13.89 millimetres, respectively. The typical vertebra’s pedicle thickness ranged from 7.12 to 11.23 millimetres. PDL, PDH, and PDTh for L5 had mean values of 8.81 mm, 12.78 mm, and 16.11 mm, respectively. Pedicle axial length increased from L1 to L3 and then decreased from L4 to L5, with the mean transverse angle of the right and left side of the pedicle at L5 being larger than L4 (16.97 degrees and 15.82 degrees). The study found that there is shows statistically significant variations in the sizes of the pedicles of each of the five lumbar vertebrae. With the exception of height, a highly significant (P < 0.01) difference was seen for all measures. Conclusion: The study has concluded that there are significant differences in dimension of pedicles of both the typical and atypical variant of lumbar vertebrae.
Abstract (English)
Introduction: An operating surgeon can carry out these treatments more accurately and safely if they are aware of slight anatomical heterogeneity. Prior to implant implantation, general orthopedic surgery guidelines encourage templating with precise measurements. It is known that there is a significant discrepancy between both the historically recorded diameter of the outer cortical and the effective cancellous diameter, suggesting that a safe screw selection might not always be possible with the use of traditional methods. It is strongly believed by the surgeon community that appropriate morphometric information on the lumbar pedicles is essential to undertake these treatments in a risk-free setting. Aims and Objectives: To determine and analyze the dimensions of lumbar vertebral pedicles in adult Indian population. Methods: This is a prospective and observational study conducted on 35 specimens of lumbar vertebrae. The study considered 35 dry, fully ossified, healthy lumbar vertebral pairs from the Department of Anatomy were used in the investigation. All vertebrae were divided into typical (L1 to L4) and atypical categories for the study (L5). The specimens were determined for variation in their dimensions and required analysis were carried out for proper analysis. Results: Pedicles in normal vertebrae (L1 to L4) ranged in length and height from 8.86 millimetres to 10 millimetres and 13.12 millimetres to 13.89 millimetres, respectively. The typical vertebra’s pedicle thickness ranged from 7.12 to 11.23 millimetres. PDL, PDH, and PDTh for L5 had mean values of 8.81 mm, 12.78 mm, and 16.11 mm, respectively. Pedicle axial length increased from L1 to L3 and then decreased from L4 to L5, with the mean transverse angle of the right and left side of the pedicle at L5 being larger than L4 (16.97 degrees and 15.82 degrees). The study found that there is shows statistically significant variations in the sizes of the pedicles of each of the five lumbar vertebrae. With the exception of height, a highly significant (P < 0.01) difference was seen for all measures. Conclusion: The study has concluded that there are significant differences in dimension of pedicles of both the typical and atypical variant of lumbar vertebrae.
Files
IJPCR,Vol15,Issue1,Article86.pdf
Files
(460.6 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:53207c4e9c386f4db52ed818d0a04b6e
|
460.6 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-01-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue1,Article86.pdf
- Development Status
- Active
References
- 1. Aruna N, Rajeshwari T. A Study of Lumbar Pedicle size in South Indians. Anatomica Karnataka 2011; 5(2): 69- 73. 2. Lotfinia I, Haddadi K, Sayyahmelli S. Computed tomographic evaluation of pedicle dimension and lumbar spinal canal. Neurosurg Q. 2010; 20:194– 198. 3. Yeramaneni S, Robinson C, Hostin R. Impact of spine surgery complications on costs associated with management of adult spinal deformity. Curr Rev Musculoskeletal Med. 2016; 9:327–32. 4. Banta CJ, 2nd, King AG, Dabezies EJ, Liljeberg RL. Measurement of effective pedicle diameter in the human spine. Orthopedics. 1989;12:939–42. 5. Misenhimer GR, Peek RD, Wiltse LL, Rothman SL, Widell EH., Jr Anatomic analysis of pedicle cortical and cancellous diameter as related to screw size. Spine (Phila Pa 1976) 1989; 14: 367–72. 6. Kaptanoglu E, Cemil B, Gurcay AG, Tun K, Cevirgen B. Morphometric characteristics of the inner and outer diameter of lumbar pedicles on computed tomography. Neurol Neurochir Pol. 2009; 43:533–7. 7. Yusof MI, Ming LK, Abdullah MS, Yusof AH. Computerized tomographic measurement of the cervical pedicles diameter in a Malaysian population and the feasibility for transpedicular fixation. Spine (Phila Pa 1976) 2006;31:E221–4.8. Singel TC, Patel MM, Gohil DV. A study of width and height of lumbar pedicles in Saurashtra region. J AnatSoc India. 2004;53:4–9. 9. Li B, Jiang B, Fu Z, Zhang D, Wang T. Accurate determination of isthmus of lumbar pedicle: a morphometric study using reformatted computed tomographic images. Spine (Phila Pa 1976) 2004;29:2438–44. 10. Kim NH, Lee HM, Chung IH, Kim HJ, Kim SJ. Morphometric study of the pedicles of thoracic and lumbar vertebrae in Koreans. Spine (Phila Pa 1976) 1994;19:1390–4. 11. Berrington de González A, Mahesh M, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med. 2009;169:2071–7. 12. Olsewski JM, Simmons EH, Kallen FC, Mendel FC, Severin CM, Berens DL. Morphometry of the lumbar spine: anatomical perspectives related to transpedicular fixation. J Bone Joint Surg Am. 1990; 72:541–549. 13. Muhammad M Alam, Muhammad Waqas, HussainShallwani, GoharJaved. Lumbar Morphometry: A Study of Lumbar Vertebrae from a Pakistani Population Using Computed Tomography Scans. Asian Spine J. 2014; 8(4): 421–26. 14. Wolf A, Shoham M, Michael S, Moshe R. Morphometric Study of the Human Lumbar Spine for Operation– Workspace Speciûcations. Spine 2001; 26(22): 2472–77. 15. Chawla K, Sharma M, Abhaya A, Kochhar S. Morphometry of the lumbar pedicle in North West India. Eur J Anat 2011; 15(3): 155-61. 16. Azu O, Komolafe OA, Ajayi SA, Naidu EC, Abiodun A. Morphometric study of lumbar vertebrae of Adult South African subjects. Int J Morphol 2016; 34(4): 1345-51. 17. Joseph Albano, Jonathan Lentz, Robert Stockton, Vincent Depalma, Michael Markowitz, MaximillianGanz et.al. Demogrphic analysis of Lumbar pedicle. Asian Spine J. 2019 Jun; 13(3): 410-416 Mitra SR, Datir SP, Jadhav SO. Morphometric study of the lumbar pedicle in the Indian population as related to pedicular screw fixation. Spine 2002; 27(5): 453-9 Chandni G, Poonam K, Arvind KP, Antony SD. Morphometrical Study of Pedicles in Lumbar Vertebrae and Its Clinical Significance. Journal of Surgical Academia 2014; 4(1):37-40. 18. Singel TC, Patel MM, Gohil DV. A study of width and height of lumbar pedicles in Saurashtra region. J AnatSoc India 2004; 53(1): 4-9. 19. Urrutia VE, Eloizondo ORE, De La Garza CO, Guzman LS. Morphometry of pedicle and vertebral body in a Mexican population by CT and Fluroscopy. Int J Morphol 2009; 27(4): 1299-1303. 20. Attar A, Ugur HC, UZ A, Tekdemir I, Egemen N, Genc Y. Lumbar pedicle: surgical anatomic evaluation and relationships. Eur Spine J. 2001; 10:10– 15.Kim NH, Lee HM, Chung IH, Kim HJ, Kim SJ. Morphometric study of the pedicles of thoracic and lumbar vertebrae in Koreans. Spine (Phila Pa 1976). 1994 Jun 15;19 (12):1390-4. 21. Amonoo-Kuofi HS. Age-related variations in the horizontal and vertical diameters of the pedicles of the lumbar spine. J Anat. 1995 Apr;186 (Pt 2)(Pt 2):321-8. 22. Olsewski JM, Simmons EH, Kallen FC, Mendel FC, Severin CM, Berens DL. Morphometry of the lumbar spine: anatomical perspectives related to transpedicular fixation. J Bone Joint Surg Am. 1990 Apr;72(4):541-9. 23. Wang Y, Kahaer A, Shi W, Guo H, Rexiti P. Morphometric measurement of lumbar pedicle in different regions: a systematic review. J OrthopSurg Res. 2023 Jan 11;18(1):30. 24. Panjabi MM, Shin EK, Chen NC, Wang JL. Internal morphology of humancervical pedicles. Spine (Phila Pa 1976) 2000;25:1197–205. 25. Singel TC, Patel MM, Gohil DV. A study of width and height of lumbar pedicles in Saurashtra region. J AnatSoc India. 2004;53:4–9. 26. Hays, P. . (2022). Evidence Basis for Pharmacogenetic Testing in Psychiatry. Journal of Medical Research and Health Sciences. 2022; 5(3): 1838–1859.