Martínez SJA, Rojas AA, Victoria BCJ, Osuna LYA, Altamirano CAA

Language: Spanish
References: 13
Page: 76-79
PDF size: 143.16 Kb.

ABSTRACT

Instrumentation in the thoracic spine is essential in the presence of instability, which is why there is great interest in the anatomical site where the implants are placed, individualized placement techniques and fixations based on their anatomy and the type of injury presented by the patient, the use of advanced imaging methods such as computed tomography is currently recommended for adequate surgical planning (pedicle thickness, safety length, optimal entry site, angulation in the sagittal and axial planes and to assess anatomical variants), multiple studies where morphometry is analyzed and it has been shown that there are multiple variations according to race, age and gender, which is why having this morphometric study of a specific Mexican population (Sonora) is of great help for decision-making in the face of absence of advanced imaging studies (CT or MRI), with our study it was possible to carry out the following recommendation endation: 1. In T1, T11 and T12, 6.5 mm diameter screws can be used. 2. In T2-T10 you can use 5.0 mm screws. 3. Extra caution should be used when instrumenting T4 as it is the smallest pedicle.

REFERENCES

1. Gaines RW Jr. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 2000; 82: 1458-1476.

2. Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K. Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2004; 29: 2040-2048.

3. Kaliya-Perumal AK, Yeh YC, Niu CC, Chen LH, Chen WJ, Lai PL. Is convex derotation equally effective as concave derotation for achieving adequate correction of selective Lenke's type- 1 scoliosis? Indian J Orthop. 2018; 52: 363-368.

4. Li K, Zhang W, Liu D, et al. Pedicle screw fixation combined with intermediate screw at the fracture level for treatment of thoracolumbar fractures: a meta-analysis. Medicine (Baltimore). 2016; 95: e4574.

5. Grivas TB, Savvidou O, Binos S, et al. Morphometric characteristics of the thoracolumbar and lumbar vertebrae in the Greek population: a computed tomography-based study on 900 vertebrae– "Hellenic Spine Society (HSS) 2017 Award Winner." Scoliosis Spinal Disord. 2019; 14: 2.

6. Berry JL, Moran JM, Berg WS, Steffee AD. A morphometric study of human lumbar and selected thoracic vertebrae. Spine (Phila Pa 1976). 1987; 12: 362-367.

7. Vaccaro AR, Rizzolo SJ, Allardyce TJ, et al. Placement of pedicle screws in the thoracic spine. Part I: morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am. 1995; 77: 1193-1199.

8. Olsewski JM, Simmons EH, Kallen FC, Mendel FC, Severin CM, Berens DL. Morphometry of the lumbar spine: anatomical perspectives related to transpedicular fixation. J Bone Joint Surg Am. 1990; 72: 541-549.

9. Hackenberg L, Link T, Liljenqvist U. Axial and tangential fixation strength of pedicle screws versus hooks in the thoracic spine in relation to bone mineral density. Spine (Phila Pa 1976). 2002; 27: 937-942.

10. Suk SI, Kim WJ, Lee SM, Kim JH, Chung ER. Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine (Phila Pa 1976). 2001; 26: 2049-2057.

11. Ebraheim NA, Jabaly G, Xu R, Yeasting RA. Anatomic relations of the thoracic pedicle to the adjacent neural structures. Spine (Phila Pa 1976). 1997; 22: 1553-1557.

12. Datir SP, Mitra SR. Morphometric study of the thoracic vertebral pedicle in an Indian population. Spine (Phila Pa 1976). 2004; 29: 1174-1181.

13. Zindrick MR, Wiltse LL, Doornik A, et al. Analysis of the morphometric characteristics of the thoracic and lumbar pedicles. Spine (Phila Pa 1976). 1987; 12: 160-166.