Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (11): 1743-1748.doi: 10.3969/j.issn.2095-4344.0173

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Measurement and clinical significance of lumbar pedicle CT imaging parameters

Guan Zhe-heng1, Yang Hui-lin1, Luo Zong-ping2, Cui Xu-dong2, Pan Xiao-yu3, Yan Mo-qi1, Wang Yi-fan2, Lu Ji-hang2   

  1. 1First Affiliated Hospital, Soochow University, Suzhou 215006, Jiangsu Province, China; 2Orthopedic Institute, South Campus of Soochow University, Suzhou 215000, Jiangsu Province, China; 3Third Hospital, Peking University, Beijing 100191, China
  • Online:2018-04-18 Published:2018-04-18
  • Contact: Yang Hui-lin, First Affiliated Hospital, Soochow University, Suzhou 215006, Jiangsu Province, China
  • About author:Guan Zhe-heng, Master, First Affiliated Hospital, Soochow University, Suzhou 215006, Jiangsu Province, China

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Abstract:

BACKGROUND: Although more and more accurate and personalized detection and assistive tools are used in the field of orthopedics with the development of technology, the preoperative CT is still the first-line examination choice of many orthopedic surgeons. Therefore, to master the lumbar spine CT imaging performance is not only the basis of spine surgeons, but also the cornerstone of spinal nail surgery.

OBJECTIVE: Through CT imaging technique, we measured the parameters of lumbar pedicle imaging, and understood its internal structure as the basis for the choice of screws, in order to improve the safety and accuracy of nail surgery.
METHODS: Totally 36 cases without lumbar vertebrae-related disease undergoing lumbar vertebra and abdominal cavity CT scan were randomly selected, including 20 males and 16 females at the age of (43.3±12.3) years. PACS was used to reconstruct lumbar vertebrae, and the related imaging parameters were measured.
RESULTS AND CONCLUSION: (1) There was no significant difference between the left and right sides of the pedicle for paired t-test (P > 0.05). (2) Pedicle sagittal angle had downward trend, the level of change was small; L4 increased relative to L3; L5 level was minimum at the average of -1.3°. Pedicle transverse angle had gradually increased trend, and maximum at L5; the average was 25.4°. (3) The length of the pedicle channel increased first and then decreased in the lumbar segment; the longest average was 52.2 mm in the L2 segment, the shortest at L5, with an average of 47.4 mm. (4) The pedicle height was slightly narrowed at L1-L3 levels; the smallest was 15.4 mm (L3 mean), and reached the maximum in the L5 at 22.7 mm (L5 mean). Cancellous bone height also showed the same trend, the minimum in the L3 at 10.2 mm, the maximum in the L5 at 17.9 mm. (5) Lumbar pedicle width showed an upward trend, L1 minimum of 7.7 mm, L5 maximum of 12.5 mm. Cancellous bone width also became a similar upward trend; the narrowest L1, averagely 4.9 mm; the maximum L5, averagely 8.5 mm. (6) Overall, the upper lumbar pedicle channel was slender, while the lower lumbar spine was slightly short. (7) The parameters of the pedicle can be used as the basis for selecting the appropriate screw. At the same time, lumbar pedicle morphology has a certain difference, and there is a certain law. Accurately grasping its structure and image characteristics of pedicle screw fixation is the basis of surgery. The preoperative imaging data collection and assessment, combined with the general situation of patients, and the development of personalized programming, will help in improving the safety and accuracy of screw placement.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebrae, Bone Nails, Tissue Engineering

CLC Number: