Association between pedicle screw dimensions and pedicle morphometry in computed tomography scans.

Area of Science:

• Spinal surgery
• Orthopedic surgery
• Radiology

Background:

• Previous research explored vertebral morphometry and pedicle breach but lacked direct correlations between pedicle size and screw dimensions.
• This study addresses the gap by investigating the relationship between pedicle morphometry and pedicle screw characteristics in thoracolumbar vertebrae.

Purpose of the Study:

• To determine the relationship between pedicle screw size and direction with the morphometry of thoracolumbar vertebral pedicles.
• To establish correlations between computed tomography (CT) scan measurements and screw placement outcomes.

Main Methods:

• Retrospective observational study of 60 adult patients with thoracic and lumbar vertebral fractures undergoing posterior spinal stabilization.
• Analysis of pre- and post-operative CT scans to assess pedicle morphometry, screw dimensions, and breach grade.
• Statistical analysis including paired tests and correlation analyses.

Main Results:

• Analysis of 177 vertebrae revealed significant post-operative increases in pedicle width and height (p < 0.001).
• No correlation was found between screw insertion angles and transverse pedicle angles.
• Narrow thoracic pedicles and screws occupying >80% of pedicle width were linked to increased breach risk (overall breach rate 23.3%).

Conclusions:

• CT morphometry is crucial for guiding pedicle screw selection in spinal stabilization.
• Screws exceeding 80% of pedicle width in narrow thoracic pedicles significantly heighten breach risk.
• Routine CT measurements facilitate accurate instrumentation and enhance surgical safety.