Pedicle Dimensions of the Thoracic Vertebrae in the Zimbabwean Adult Male Population: A Cadaveric Study

  • Maimoona Khan Mohiuddin Islamic Medical College
  • Takana Bill Nyamandi
  • Tapera Makosa
Keywords: Chord length, Pedicle dimensions, Thoracic vertebrae

Abstract

Objective:   To record the dimensions of thoracic-vertebrae pedicles in the grown-up community of Zimbabwe.

Study design:   A cross-sectional descriptive study.

Place and duration of studyA six-month study carried out in the Anatomy Department (Gross Anatomy Laboratory), University of Zimbabwe, College of Health Sciences, Harare (from May 2019 to November 2019).

Material and Methods:.  The thoracic vertebrae from 15 adult male cadavers were dissected out and Pedicle External Sagittal Diameter (PESD), Pedicle External Transverse Diameter (PETD) and chord length were measured using a vernier caliper and compared (on right and left sides). The statistical analysis was done using SPSS version 23, with data expressed as means, standard deviation and ranges. Student’s t-test was used to estimate the difference in pedicle dimensions of the right and left sides of the thoracic vertebrae.

Results:  There was a significant difference between the right and left pedicle dimensions in chord length at the level of T9, PESD at levels T6 and T7, and PETD at levels T2, T6, T7 and T11. PESD values were noted to be increasing from thoracic vertebrae T1 to T12 with a plateau phase noted from T2-T7.  PETD values decreased from T1-T5 and then gradually increased to T12.  Chord length increased gradually from T1-T12.

Conclusion:  Pedicle dimensions differ between the Zimbabwean population and other ethnic groups of earlier investigations.  Furthermore, there was a significant difference between the right and left pedicles in terms of PETD, PESD and Chord length.

References

1. Lee CS, Cho JH, Hwang CJ, Lee DH, Park JW, Park KB. The importance of the pedicle diameters at the proximal thoracic vertebrae for the correction of proximal thoracic curve in Asian patients with idiopathic scoliosis. Spine. 2019 Jun 1;44(11):E671-8.
2. Bianco RJ, Arnoux PJ, Mac-Thiong JM, Aubin CE. Thoracic pedicle screw fixation under axial and perpendicular loadings: a comprehensive numerical analysis. Clinical Biomechanics. 2019 Aug 1;68:190-6.
3. Datir SP, Mitra SR. Morphometric study of the thoracic vertebral pedicle in an Indian population. Spine. 2004 Jun 1;29(11):1174-81.
4. Liu H, Wang Y, Pi B, Qian Z, Zhu X, Yang H. Comparison of intraoperative O-arm-and conventional fluoroscopy (C-arm)-assisted insertion of pedicle screws in the treatment of fracture of thoracic vertebrae. Journal of Orthopaedic Surgery. 2017 Jan 18;25(1):2309499016684090.
5. Solitro GF, Whitlock K, Amirouche F, Mehta AI, McDonnell A. Currently adopted criteria for pedicle screw diameter selection. International journal of spine surgery. 2019 Apr 1;13(2):132-45.
6. Meng XT, Guan XF, Zhang HL, He SS. Computer navigation versus fluoroscopy-guided navigation for thoracic pedicle screw placement: a meta-analysis. Neurosurgical review. 2016 Jul;39(3):385-91.
7. Matsukawa K, Yato Y, Hynes RA, Imabayashi H, Hosogane N, Asazuma T, Matsui T, Kobayashi Y, Nemoto K. Cortical bone trajectory for thoracic pedicle screws: a technical note. Clinical spine surgery. 2017 Jun 1;30(5):E497-504.
8. Mohanty SP, Kanhangad MP, Bhat SN, Chawla S. Morphometry of the lower thoracic and lumbar pedicles and its relevance in pedicle fixation. Musculoskeletal surgery. 2018 Dec;102(3):299-305.
9. Pan Y, Lü GH, Kuang L, Wang B. Accuracy of thoracic pedicle screw placement in adolescent patients with severe spinal deformities: a retrospective study comparing drill guide template with free-hand technique. European Spine Journal. 2018 Feb;27(2):319-26.
10. Chen H, Guo K, Yang H, Wu D, Yuan F. Thoracic pedicle screw placement guide plate produced by three-dimensional (3-D) laser printing. Medical science monitor: international medical journal of experimental and clinical research. 2016;22:1682.
11. Yuan Q, Zhang G, Wu J, Xing Y, Sun Y, Tian W. Clinical evaluation of the polymethylmethacrylate-augmented thoracic and lumbar pedicle screw fixation guided by the three-dimensional navigation for the osteoporosis patients. European Spine Journal. 2015 May;24(5):1043-50.
12. Verma V, Santoshi JA, Jain V, Patel M, Dwivedi M, Nagar M, Selvanayagam R, Pal D. Thoracic pedicle morphometry of dry vertebral columns in relation to trans-pedicular fixation: A cross-sectional study from central india. Cureus. 2020 May;12(5).
13. Gonzalvo A, Fitt G, Liew S, de la Harpe D, Vrodos N, McDonald M, Rogers MA, Wilde PH. Correlation between pedicle size and the rate of pedicle screw misplacement in the treatment of thoracic fractures: Can we predict how difficult the task will be?. British journal of neurosurgery. 2015 Jul 4;29(4):508-12.
14. Badmus O, Ogbe P, Olowoyeye OA, Akinsulire A, Omidiji O. Measurement of thoracic and lumbar pedicle dimensions in Nigerians using computed tomography. Port Harcourt Medical Journal. 2020 Jan 1;14(1):12.
15. Wang K, Zhang ZJ, Chen JX, Wu AM, Wang XY, Sheng SR. Design and application of individualized, 3-dimensional-printed navigation template for placing cortical bone trajectory screws in middle-upper thoracic spine: cadaver research study. World neurosurgery. 2019 May 1;125:e348-52.
16. Peh S, Chatterjea A, Pfarr J, Schäfer JP, Weuster M, Klüter T, Seekamp A, Lippross S. Accuracy of augmented reality surgical navigation for minimally invasive pedicle screw insertion in the thoracic and lumbar spine with a new tracking device. The Spine Journal. 2020 Apr 1;20(4):629-37.
17. Solitro GF, Amirouche F. Innovative approach in the development of computer assisted algorithm for spine pedicle screw placement. Medical engineering & physics. 2016 Apr 1;38(4):354-65.
18. Muteti EN, ElBadawi MG. Morphometry of the thoracic pedicle and the pedicle-rib unit: A review of literature. East African Orthopaedic Journal. 2018;12(2):67-72.
19. Gao, B., Gao, W., Chen, C., Wang, Q., Lin, S., Xu, C., Huang, D. and Su, P., 2017. What is the difference in morphologic features of the thoracic pedicle between patients with adolescent idiopathic scoliosis and healthy subjects? A CT-based case-control study. Clinical Orthopaedics and Related Research®, 475(11), pp.2765-2774.
20. Tamburrelli FC, Perna A, Proietti L, Zirio G, Santagada DA, Genitiempo M. The feasibility of long-segment fluoroscopy-guided percutaneous thoracic spine pedicle screw fixation, and the outcome at two-year follow-up. Malaysian orthopaedic journal. 2019 Nov;13(3):39.
21. Hou Y, Lin Y, Shi J, Chen H, Yuan W. Effectiveness of the thoracic pedicle screw placement using the virtual surgical training system: a cadaver study. Operative Neurosurgery. 2018 Dec 1;15(6):677-85.
22. Charles YP, Ntilikina Y, Collinet A, Schuller S, Garnon J, Godet J, Clavert P. Accuracy and technical limits of percutaneous pedicle screw placement in the thoracolumbar spine. Surgical and Radiologic Anatomy. 2021 Jan 15:1-1.
23. Xuan J, Chen J, He H, Jin HM, Zhang D, Wu YS, Tian NF, Wang XY. Cortical bone trajectory screws placement via pedicle or pedicle rib unit in the pediatric thoracic spine (T9-T12): A 2-dimensional multiplanar reconstruction study using computed tomography. Medicine. 2017 Feb;96(5).
24. Sugawara T, Kaneyama S, Higashiyama N, Tamura S, Endo T, Takabatake M, Sumi M. Prospective multicenter study of a multistep screw insertion technique using patient-specific screw guide templates for the cervical and thoracic spine. Spine. 2018 Dec 1;43(23):1685-94.
25. Farshad M, Betz M, Farshad-Amacker NA, Moser M. Accuracy of patient-specific template-guided vs. free-hand fluoroscopically controlled pedicle screw placement in the thoracic and lumbar spine: a randomized cadaveric study. European Spine Journal. 2017 Mar;26(3):738-49.
26. Hu, Y., Yuan, Z.S., Spiker, W.R., Dong, W.X., Sun, X.Y., Yuan, J.B., Zhang, J. and Zhu, B., 2016. A comparative study on the accuracy of pedicle screw placement assisted by personalized rapid prototyping template between pre-and post-operation in patients with relatively normal mid-upper thoracic spine. European Spine Journal, 25(6), pp.1706-1715.
Published
2022-03-31
How to Cite
1.
Khan M, Nyamandi T, Makosa T. Pedicle Dimensions of the Thoracic Vertebrae in the Zimbabwean Adult Male Population: A Cadaveric Study. JRMC [Internet]. 31Mar.2022 [cited 27May2022];26(1):72-7. Available from: https://journalrmc.com/index.php/JRMC/article/view/1733