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Related Experiment Videos

Anatomic relation between the cervical pedicle and the adjacent neural structures.

R Xu1, A Kang, N A Ebraheim

  • 1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.

Spine
|March 20, 1999
PubMed
Summary

Cervical pedicle screw fixation carries risks. This study found no space between pedicles and superior nerve roots or the dura, suggesting medial or superior screw placement increases neurologic injury risk.

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Anatomy

Background:

  • Transpedicular screw fixation is used in cervical spine surgery.
  • Quantitative data on cervical pedicle-neural structure relationships is limited.

Purpose of the Study:

  • To quantitatively determine the anatomical relationship between cervical pedicles and adjacent nerve roots and the dural sac.
  • To provide data for safer cervical pedicle screw placement.

Main Methods:

  • Dissection of 20 cadavers to expose cervical pedicles (C3-C7), nerve roots, and dural sac.
  • Direct measurements of distances between pedicles and neural structures.
  • Measurement of pedicle height and width at the isthmus.

Main Results:

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  • No distance observed between pedicles and superior nerve roots or dural sac (C3-C7).
  • Mean distance to inferior nerve roots ranged from 1.4-1.6 mm.
  • Mean pedicle dimensions: height 6.0-6.5 mm, width 4.7-5.3 mm. Significant sex-based differences in height and width noted.

Conclusions:

  • Neurologic injury risk may be higher with medial or superior pedicle screw cortex penetration.
  • Findings highlight the critical proximity of cervical pedicles to neural elements.