What is the difference in morphologic features of the lumbar vertebrae between Caucasian and Taiwanese subjects? A CT-based study: implications of pedicle screw placement via Roy-Camille or Weinstein method

• Published in: BMC musculoskeletal disorders Vol. 20; no. 1; pp. 252 - 7
• Main Authors: Lin, Hsi-Hsien, Wang, Jung-Pan, Lin, Cheng-Li, Yao, Yu-Cheng, Wang, Shih-Tien, Chang, Ming-Chau, Chou, Po-Hsin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25.05.2019; BioMed Central; BMC
• Subjects: Anatomic study; Bone surgery; CAT scans; Computed tomography; Diagnostic imaging; Lumbar vertebrae; Medical imaging; Methods; Morphology; Pedicle screws; Population; Racial difference; Roy-Camille method; Scoliosis; Spine (lumbar); Surgery; Vertebrae; Weinstein method; Taiwan; Anatomic study; Roy-Camille method; Weinstein method; Pedicle screws; Racial difference
• DOI: 10.1186/s12891-019-2602-4
• ISSN: 1471-2474

Safe placement of pedicle screws without jeopardizing neurovascular structures medially and anteriorly is important during spine surgery. Inferior breach of pedicle is also dangerous due to low margin of error. Lumbar morphology and identical pedicle orientation at L1 to L5 shown on CT scan of young Taiwanese patients (90 patients) were analyzed and compared with findings reported for Caucasian subjects. Previously reported techniques were employed to quantitatively elucidate the parameters regarding lumbar morphology and identical pedicle orientation at each vertebra. The parameters for pedicle angle (PA), pedicle diameter (PD), pedicle axis distance (PAD), midline axis distance (MAD), transverse pedicle axis distance (TPAD) and transverse intertangential angle (TITA) were measured. Taiwanese subjects had different PA, PD, PAD, MAD at L1 to L5 and TITA at L3 to L5 compared with Caucasian subjects. L5 had the most convergent pedicle axis, the widest PD and the shortest antero-posterior axis morphology. This study provides detailed information for identifying pedicle orientation during pedicle screw placement and elucidate racial differences in lumbar morphology and pedicle orientation between Taiwanese and Caucasian populations.