IJCRR - Vol 06 Issue 13, July, 2014
MORPHOMETRY OF THE FIRST SACRAL PEDICLE IN SOUTH INDIAN POPULATION
Author: Padmavathi Devi S. V., T. Rajini, Varsha Mokhasi
Instrumentation of the sacrum is increasing in importance in treatment of spinal disorders, sacro-iliac joint disturbances and sacral fractures. There is concern about injuries to pedicle cortex, nerve root, facet joint, iliac vein penetration and other vital structures by a misplaced or a misdirected pedicle screw. In this study Description of the Morphometry of the sacral pedicles of Indian samples has been done. 100 dry sacral vertebrae were used for the morphometric analysis of the first sacral pedicle (57 male and 43 female) using vernier calliper (0.1mm) and goniometer. The height of the first sacral pedicle in male was 19.30±1.6mm and in female was 18.46±1.8mm. The width of the first sacral pedicle was 24.06±2.4mm in male and 23.48±2.3mm in female. The anteromedial trajectory length in male was 46.88±3.2mm and in female was 43.35±3.7mm. The anterolateral trajectory length in male was 45.78±3.5mm and in female was 44.02±2.2mm. The medial trajectory angle in the male was 34.28±2.5mm and in female was 32.08±2.4mm. The lateral trajectory angle in the male was 28.33±3.4mm and in the female was 25.58±2.8mm. The results of this study will guide surgeons on the choice of the screws that are used for pedicle fixation and their direction of insertion. A detailed knowledge of the morphometric anatomy of the sacral pedicles will minimize surgical complications.
Keywords: Sacrum, Pedicle, Screw fixation, Sacral pedicle
Padmavathi Devi S. V., T. Rajini, Varsha Mokhasi. MORPHOMETRY OF THE FIRST SACRAL PEDICLE IN SOUTH INDIAN POPULATION International Journal of Current Research and Review. Vol 06 Issue 13, July, 38-44
1. Deepak Awasthi and Najeeb Thomas, Pedicle, cited at http://www.medschool.lsuhsc.edu/neurosurger y/nervecenter/tlscrew.html Accessed on 14.4.14.
2. Weinstein JN, RydevikBL, Rauschning W. Anatomic and technical considerations of pedicle screw fixation.Clin Orthop Relat Res. 1992 Nov;(284):34-46.
3. Harrington PR, Dickson JH. Spinal Instrumentation in the treatment of severe progressive spondylolistheses. Clin.Orthop,1976(117),157-163
4. Candan Arman , Sait Naderi , Amac Kiray , Funda Tastekin Aksu , Hakan Sinan Y?lmaz , Suleyman Tetik, Esin Korman, The human sacrum and safe approaches for screw placement, Journal of Clinical Neuroscience 16 (2009) 1046–1049
5. Ozerk Okutan, Erkan Kaptanoglu, Ihsan Solaroglu, Etem Beskonakli, Ibrahim Tekdemir, Pedicle morphology of the first sacral vertebra, Neuroanatomy, 2003, Volume 2, Pages 16-19.
6. Xu R, Ebraheim NA, Yeasting RA, et al. Morphometric evaluation of the first sacral vertebra and the projection of its pedicle on the posterior aspect of the sacrum. Spine 1995;20:936–40.
7. Rongming Xu,Nabil A,Ebraheim, MD, and Nicholas K Gove,MD. Surgical anatomy of the sacrum, Am J Orthop. 2008;37(10):E177- E181
8. Ebraheim NA, Xu R, Li J,Yeasting R, Computed Tomographic consideratioms of dorsal screw placement.J Spinal Discord. 1998:11(!):71-74
9. Mirkovic S, Abitbol JJ, Steinman J, et al. Anatomic consideration for sacral screw placement. Spine 1991;16:S289–94.
10. Morse BJ, Ebraheim NA, JacksonT. Preoperative CT determination of angles for screw placement. Spine 1994;19:604-7
11. Peretti F, Argenson C, Bourgeon A, Omar F, Eude P, Aboulker C. Anatomic and experimental basis for the insertion of a screw at the first sacral vertebra. Surg. Radiol. Anat. 1991 (13) 133-137.