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Published on: November 8, 2024
The Computed Tomography-based Morphometry of Thoracolumbar Junction (T11-L2) in Western Indian Population:
Sandeep Kumar Yadav1, Rama Kishan2, Kishore Parihar1
1Department of Orthopedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Introduction:
Morphometric data for safe transpedicular screw placement at the thoracolumbar junction (T11-L2) remain limited for Indian populations, despite ethnic variations affecting screw sizing and complications. This study provides prospective computed tomography-based reference values for Western India.
Materials And Methods:
Prospective analysis of 200 consecutive adults (≥20 years; 110 males, 90 females) with back pain but normal thoracolumbar imaging (June 2021-August 2023) at a Western Indian tertiary center was conducted. Ethical approval taken from Institutional Ethics Committee, AIIMS Jodhpur (IEC No.- AIIMS/IEC/2022/4070). The bilateral pedicle width, interpedicular distance (IPD), anterior cortex depth, and transpedicular angle measured at T11-L2 using digital imaging and communications in medicine viewer (1-2 mm slices). Means ± standard deviation were compared by sex using unpaired t-tests (P < 0.05 significant; Excel).
Results:
Pedicle width increased caudally (T11: 5.14 ± 0.87 mm; L2: 6.39 ± 0.89 mm), with male > female at T12/L1 (P < 0.01). IPD rose from T11 (1.74 ± 0.20 cm) to L2 (2.15 ± 0.20 cm; L1 P = 0.039 by sex). Transpedicular angle: T11 (19.96 ± 2.20°) to L2 (23.06 ± 1.42°; all P < 0.05 by sex). Anterior cortex depth peaked at L1 (5.05 ± 0.86 cm). Safe screws: Thoracic 4.5-5.5 mm, lumbar 5.5-6.5 mm.
Conclusion:
Western Indian norms show narrower pedicles than Western data, aligning with other Indian series but adding a T11-L2 focus. This aids in ethnicity-specific screw selection to reduce misplacement in thoracolumbar fixation.