MORPHOMETRY OF THE SUBAXIAL CERVICAL SPINE PEDICLES IN THE ANATOLIAN POPULATION

Abstract

Objective: Transpedicular screw fixation for the subaxial cervical spine is considered to be more stable than other posterior fixation techniques despite its technical challenges. Thorough understanding of cervical pedicle anatomy and morphometric parameters is essential to avoid neurovascular injury during screw placement. To evaluate subaxial cervical spine pedicle dimensions, screw starting points, and screw trajectories to provide data that might be representative of the entire Anatolian peninsula. Materials and Methods: This retrospective study included 200 patients (2000 cervical pedicles). The distance from the junction of the lamina and spinous process to the entry point (DEP), pedicle width (PW), pedicle maximum axis length (PAL), pedicle transverse angle (PTA) in the axial plane, and pedicle height (PH) in the sagittal plane were measured from C3 to C7 on computed tomography (CT) by two blinded observers. Results: The mean values for DEP, PW, PAL, PTA and PHA ranged between 22.92 mm-23.75 mm, 4.99 mm-6.26 mm, 28.24 mm-36.01 mm, 33.52°- 34.60° and 6.36 mm-7.03 mm, respectively. The PW significantly increased in the rostrocaudal direction. The PAL was significantly different between the right and left sides at C3 in male patients. The PTA was significantly different between the right and left sides at C3 in female patients. The PH was greater than the PW at all levels on both sides. Conclusion: Although surgical planning should be carried out on a case-by-case basis, the findings of the present study might be helpful for Turkish spine surgeons in decision-making for the accurate placement of cervical pedicle screws.