การเปรียบเทียบระหว่างการใช้ Computed Tomography (CT) Scan กับ Magnetic Resonance Imaging (MRI) ในการวางแผนผ่าตัดยึดตรึงกระดูกคอ ส่วนล่างด้วยอุปกรณ์ชนิด Pedicle Screw

Jakkrit Keeratiruangrong

doi:10.1016/hscr.v39i1.269055

Authors

Jakkrit Keeratiruangrong Department of Orthopaedic Surgery, Uttaradit Hospital

DOI:

https://doi.org/10.1016/hscr.v39i1.269055

Keywords:

Subaxial cervical spine, Pedicle screw, Computed tomography, Magnetic resonance imaging

Abstract

ABSTRACT
Objective: The aim of study is to compare the morphology of subaxial cervical pedicles (C3-7 cervical pedicles) in computed tomography (CT) Scan and magnetic resonance imaging (MRI) and assess the ability of MRI for preoperative pedicle screw planning.
Methods: The retrospective cohort study included the CT scan and MRI of 10 patients (100 subaxial cervical pedicles) who are over 18-year-old patient that performed in Uttaradit hospital during January 2022-December 2023. This study compares the pedicle parameters (Outer pedicle width (OPW), Outer pedicle height (OPH), Pedicle axis Length (PAL) and Pedicle transverse angle (PTA)) between CT scan which is gold standard for assessing the bony structure and MRI.
Results: The overall parameters included OPW, OPH and PAL of subaxial cervical pedicle morphology in MRI are significantly less than in CT scan. (4.40±1.00 vs 5.32±0.85, 4.72±0.93 vs 5.98±0.84, 31.51±2.35 vs 33.03±3.20 millimeter) (P<0.001) except PTA that is no significant difference between 2 groups (39.77±3.91 vs 39.22±3.64 degree) (P=0.254). The mean difference of OPW, OPH and PAL between two groups are 0.92 ± 0.63, 1.26 ± 0.84 and 1.53 ± 2.57 millimeter which are significant correlation (r=0.776,
0.552, 0.611) (P<0.001). Bland-Altman plots show limit of agreement (LoA) range from -0.32 to 2.16, -0.39 to 2.91 and -3.50 to 6.56.
Conclusions: Pedicle size in MRI is smaller than CT scan. So, it is safely to perform the pedicle screw fixation if pedicle parameters in MRI are large enough. The PTA in MRI can be guiding the direction of screw insertion as same as in CT scan. However, surgeon should be aware of short screw length when using parameter in MRI.
Keywords: Subaxial cervical spine, Pedicle screw, Computed tomography, Magnetic resonance imaging

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