Computed Tomography-based Morphometric Analysis of Dorsal Vertebral Pedicle in South Indian Population

Abstract

Background: The pedicle of the thoracic vertebrae (dorsal pedicle) is a cylindrical anatomical structure that bridges between the vertebral body and posterior elements. Hence, pedicle screw fixation allows stable-3-column fixation of the spine which is biomechanically superior to other methods of spinal fixation. The dorsal pedicle has a complex anatomy and its morphological characteristics vary between different ethnic populations. Hence, the present study was planned to assess the morphological characteristics of dorsal pedicle in our local population. Materials and methods: A retrospective analysis of 648 dorsal vertebrae of 54 patients (40 males and 14 females), who were all over 20 years of age was performed and compared with previously reported studies using established methods. Results: Dorsal pedicle morphometric parameters showed significant variations between gender and different ethnic population despite having a similar general pattern. Smaller pedicle width, axis length, and medial angulation of transverse pedicle angle were unique to the South Indian population in this study cohort. Females had smaller pedicle sizes when compared to males in this study. Conclusion: The morphological differences suggest caution needs to be taken for transpedicular fixation in the Indian population with Western surgical instruments, especially in the mid-thoracic region and particularly in South Indian females who have significantly smaller and shorter pedicles.

Keywords

• anatomy
• morphometry
• screw instrumentation
• spinal surgery
• thoracic pedicle