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Anatomic relations between the lumbar pedicle and the adjacent neural structures
N A Ebraheim1, R Xu, M Darwich
1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
Spine
|November 14, 1997
Summary
This study quantified lumbar spine anatomy, revealing critical distances between pedicles and neural structures. Avoiding medial or caudal pedicle screw placement is crucial to prevent neurological injury.
Area of Science:
- Spinal anatomy
- Neurosurgery
- Orthopedic surgery
Background:
- Posterior transpedicular screw fixation is standard for lumbar spine stabilization.
- Understanding lumbar pedicle anatomy is vital to prevent neurological complications during screw placement.
Purpose of the Study:
- To quantitatively determine the anatomical relationships between the lumbar pedicle and the adjacent dural sac and nerve roots.
- To provide precise measurements for safe pedicular screw placement in the lumbar spine.
Main Methods:
- Anatomical parameters were analyzed in 15 adult cadavers.
- Direct measurements were taken from the lumbar pedicle to the dural sac, superior and inferior nerve roots, and between pedicles.
- Nerve root diameter and angle were also measured.
Main Results:
- Mean distance from lumbar pedicle to dural sac: 1.5 mm medially.
- Mean distance from lumbar pedicle to nerve roots: 5.3 mm superiorly, 1.5 mm inferiorly.
- Interpedicular distances ranged from 23.2-24.4 mm; nerve root diameters 3.8-4.6 mm; angles 33.7-39.2 degrees.
Conclusions:
- Medial or caudal pedicle screw misplacement in the lumbar spine should be avoided.
- Precise anatomical knowledge aids in preventing neurological damage during spinal instrumentation.
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