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Journal of Korean Neurosurgical Society 2009;46(4): 317-321.
doi: https://doi.org/10.3340/jkns.2009.46.4.317
Pedicle Morphometry for Thoracic Screw Fixation in Ethnic Koreans : Radiological Assessment Using Computed Tomographic Myelography.
Yong Soo Choi, Young Jin Kim, Hyeong Joong Yi, Young Joon Kim
1Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea. spine1225@yahoo.co.kr
2Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
In the thoracic spine, insertion of a pedicle screw is annoying due to small pedicle size and wide morphological variation between different levels of the spine and between individuals. The aim of our study was to analyze radiologic parameters of the pedicle morphometry from T1 to T8 using computed tomographic myelography (CTM) in Korean population. METHODS: For evaluation of the thoracic pedicle morphometry, the authors prospectively analyzed a consecutive series of 26 patients with stable thoracic spines. With the consent of patients, thoracic CTM were performed, from T1 to T8. We calculated the transverse outer diameters and the transverse angles of the pedicle, distance from the cord to the inner cortical wall of the pedicle, and distance from the cord to the dura. RESULTS: Transverse outer pedicle diameter was widest at T1 (7.66 +/- 2.14 mm) and narrowest at T4 (4.38 +/- 1.55 mm). Transverse pedicle angle was widest at T1 (30.2 +/- 12.0degrees) and it became less than 9.0degrees below T6 level. Theoretical safety zone of the medial perforation of the pedicle screw, namely, distance from the cord to inner cortical wall of the pedicle was more than 4.5 mm. CONCLUSION: Based on this study, we suggest that the current pedicle screw system is not always suitable for Korean patients. Computed tomography is required before performing a transpedicular screw fixation at the thoracic levels.
Key Words: Korean; Thoracic vertebrae; Pedicle screw; Safety zone
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