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KMID : 0361620070420020255
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Journal of the Korean Orthopaedic Association
2007 Volume.42 No. 2 p.255 ~ p.263
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Morphologic Feasibility of Pedicle Screw Insertion in Korean
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Ahn Myun-Whan
Han Jae-Hyeung
Koo Ja-Woong
Chung Sung-Min
Cho Jae-Ho
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Abstract
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Purpose: This study examined the morphological characteristics of the thoracic and lumbar vertebrae of normal Koreans and the factors causing breakage of the pedicular wall by measuring the thoracolumbar vertebrae relative to the pedicle screw insertion.
Materials and Methods: The effect of the pedicle screw shape on the pedicle wall integrity of 56 normal Koreans was examined by performing a computer simulation of the inserting pedicle screws into the pedicle wall by superimposing the graphical images of the screws onto the CT scan images.
Results: Because the inner pedicle diameters of the most thoracic vertebrae from T4 to T10 were ＜5 mm, most pedicles of the thoracic vertebrae were expected to be broken after inserting the 5 mm-diameter cylindrical screws. The pedicles of the thoracic and lumbar vertebrae were classified into 6 groups by performing the cluster analysis using morphometric parameters. Group 1 was labeled " relatively narrow" . Group 2 " moderate" . Group 3 " wide and angular" . Group 4 " severly narrow and short" , Group 5 " long" , and group 6 " relatively wide and angular" . The simulation showed the pedicles of groups 1 and 4 to be too narrow for the 5 mm-diameter cylindrical screws to preserve the pedicular wall integrity.
Conclusion: The pedicles of the vertebra of Koreans are similar in size to those of Caucasians. Personal morphological characteristics of the pedicles as well as their sizes and levels of the vertebrae are believed to be the significant factors that can cause the breakage of the pedicular wall.
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KEYWORD
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Thoracolumbar spine, Morphology of pedicle, Pedicle screw
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