Mughir, Abdullah Mohamed Abdo
(2008)
Radiological anatomy of the lumbar pedicles in malay population using reformatted computed tomography images.
Masters thesis, Universiti Sains Malaysia.
Abstract
Overview: The nonnal measurements of the lumbar pedicles well provide crucial
information for spinal instrumentation, spinal management and useful guidelines for the
use of devices. One of the spinal instrumentation used through the pedicle is pedicle
screw as a fixation device for poste1ior spinal instmmentation. The use of pedicle screw
had become increasingly popular in the recent years. For proper implant placement. an
accurate knowledge of the pedicle morphology is of utmost importance for the safe
placement of pedicle screw. Improper implant placement will lead to devastating
neurological consequences to the patient.
Objectives: The main objective of this study was to obtain a database for the
morphometry of lumbar pedicles from LI to L5 of the normal Malay population treated
in Hospital USM.
Methodology: hundred twenty six (126) patients (74 adults and 52 pediatrics) were
included in this cross-sectional retrospective study. Archived Computed Tomography
(CT) images of abdomen performed for those patients diagnosed of cancer for the
purpose of staging or for other abdominal pathologies were obtained from the Radiology
Department of Hospital Universiti Sains Malaysia. Axial CT scan images of lumbar
vertebrae (LI to LS) were obtained using a General Elect1ic CT scanner (GE Medical
Overview: The nonnal measurements of the lumbar pedicles well provide crucial
information for spinal instrumentation, spinal management and useful guidelines for the
use of devices. One of the spinal instrumentation used through the pedicle is pedicle
screw as a fixation device for poste1ior spinal instmmentation. The use of pedicle screw
had become increasingly popular in the recent years. For proper implant placement. an
accurate knowledge of the pedicle morphology is of utmost importance for the safe
placement of pedicle screw. Improper implant placement will lead to devastating
neurological consequences to the patient.
Objectives: The main objective of this study was to obtain a database for the
morphometry of lumbar pedicles from LI to L5 of the normal Malay population treated
in Hospital USM.
Methodology: hundred twenty six (126) patients (74 adults and 52 pediatrics) were
included in this cross-sectional retrospective study. Archived Computed Tomography
(CT) images of abdomen performed for those patients diagnosed of cancer for the
purpose of staging or for other abdominal pathologies were obtained from the Radiology
Department of Hospital Universiti Sains Malaysia. Axial CT scan images of lumbar
vertebrae (LI to LS) were obtained using a General Elect1ic CT scanner (GE Medical
outer and inner diameter, lateral cortical thickness at L2, transverse pedicle angle at L3-
L5, however there were no significant statistical differences between male and female in
medial coitical thickness. lateral cortical thickness except L2,pedicle length, transverse
pedicle angle except L3 and sagittal angle except L3-L5.
A significant statistical difference in transverse outer, inner diameter and pedicle length
between pediatrics and adult in male all at levels ,medial cortical thickness, lateral
cortical thickness ,transverse pedicle angle and sagittal angle at almost all levels in male.
No significant statistical difference between pediatrics and adult in female group at
almost all levels in transverse outer and inner diameter, medial and lateral co1tical
thickness, pedicle length, sagittal angle.
Conclusion:
The trends of our measurements were same as the western and other Asian population.
However our measurements were close to other Asian and smaller compare to westerns.
Almost there were no significant differences between right and left in pediatric group and
also the adult group except the transverse outer diameter in adult group. There were
significant differences between male and female in almost all levels, however these
differences were noted in outer and ilmer diameter in pediatric group.
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