Morphological study of subaxial cervical pedicles by using three-dimensional computed tomography reconstruction image

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Radiology

Background:

• Cervical pedicle screw fixation offers rigidity and fusion but risks neurovascular injury if screws are malpositioned.
• Accurate anatomical data is essential for safe screw placement.

Purpose of the Study:

• To assess the dimensions and axis of the C3-C7 cervical pedicles in the Thai population.
• To provide guidelines for safe cervical pedicle screw insertion.

Main Methods:

• Computed tomography (CT) scans of 30 Thai adults (15 male, 15 female) were analyzed.
• Three-dimensional reconstructions were used to measure pedicle dimensions (PAL, PL-LM, PL, OPW, PTA, OPH, PSA).

Main Results:

• Cervical pedicle outer height and width were suitable for 3.5 mm screws.
• Pedicle sagittal angle varied from cranial at C3-C5 to caudal at C6-C7.
• Females generally had smaller pedicle dimensions than males, but screw suitability was consistent.

Conclusions:

• Cervical pedicle screw fixation is feasible in the Thai population.
• Detailed anatomical measurements support safe screw insertion with appropriate preoperative planning.