โครงการศึกษาลักษณะทางกายวิภาคของ pedicle ในกระดูกสันหลังส่วนคอ ทรวงอก และเอวในคนไทย

Abstract

To identify the surgically parameters of transverse pedicle isthmus width transverse pedicle isthmus height and depth to anterior cortex along the pedicle axis and compare the results with those of similar studies in literature. Materials and Methods: 30 dried cadaveric vertebrae (C3- L5) were measured by four examiners two of examiners are an orthopaedists and the other are a staff of anatomy division. The 657 vertebrae were measured with caliper. The parameters that were measured included of transverse pedicle isthmus width (PDW) transverse pedicle isthmus height (PDH) and the depth to anterior cortex along the pedicle axis (In our study this term as called Anterior penetrated distance/APD). The mean of each parameter was compared to the results of previous similar studies. Results: The mean PDH of cervical spine was least at C6 (6.36 mm) thoracic spine at T1 (8.92 mm) and lumbar spine at L4 (13.05 mm). The greatest of the mean PDH in cervical spine was at C7(6.89 mm) T12(15.84mm) in thoracic spine and L1 (14.56 mm) in lumbar spine. The mean PDW of cervical level was least at C3 and C4 (5.12 mm) thoracic level at T4 (4.08 mm) and lumbar level at L1 (7.07 mm). The greatest of the mean PDW was at C7 (5.28 mm) in cervical level T11 (8.45 mm) in thoracic level and L5 (15.37 mm) in lumbar level. The mean APD of cervical spine was least at C5 (26.88 mm) thoracic spine at T1 (29.11 mm) and lumbar spine at L4 (40.74mm). The greatest mean APD of cervical level was C1 (28.39 mm) T12 (37.88 mm) in thoracic level and L4 (42.98 mm)  in lumbar level. Conclusion: In the cervical level the mean PDH and PDW of Thai people are not smaller than the White but the mean APD is significant smaller than the White. In the thoracic level the mean PDH of Thai people are smaller than the White except T 5. The mean PDW of T3-T9 are smaller than the White in contrast with the mean PDW of T1,T2 ,T10, T11, T12. In the lumbar level the PDW of Thai is smaller than the White but bigger than an Indian. The mean PDH of Thai are larger than White except L2. We found that the mean PDH are grater than the mean PDW in all level of vertebrae then a size of pedicle screw should be depended on the mean PDW.