Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis

Abstract Introduction Screw insertion during scoliosis surgery uses free-hand pedicle screw insertion methods. However, there is a wide variation in pedicle shapes, sizes, and morphometry, especially in scoliosis patients. CT scan pedicle measurements in main thoracic Lenke type 1 adolescent idiopat...

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Main Authors: Yudha Mathan Sakti, Zikrina Abyanti Lanodiyu, Mahardhika Ichsantyaridha, Sonny Wijanarko, Muhammad Riyad Filza, Taufan Taufan, Dwi Budhi Susanto, Yunus Oksikimbawan Tampubolon, Anak Agung Ngurah Nata Baskara, Aidil Akbar Nurshal, Fuad Dheni Mustofa, Annissa Rosfadilla, Rahadyan Magetsari, Tedjo Rukmoyo
Format: Article
Language:English
Published: BMC 2023-02-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-022-01877-5
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author Yudha Mathan Sakti
Zikrina Abyanti Lanodiyu
Mahardhika Ichsantyaridha
Sonny Wijanarko
Muhammad Riyad Filza
Taufan Taufan
Dwi Budhi Susanto
Yunus Oksikimbawan Tampubolon
Anak Agung Ngurah Nata Baskara
Aidil Akbar Nurshal
Fuad Dheni Mustofa
Annissa Rosfadilla
Rahadyan Magetsari
Tedjo Rukmoyo
author_facet Yudha Mathan Sakti
Zikrina Abyanti Lanodiyu
Mahardhika Ichsantyaridha
Sonny Wijanarko
Muhammad Riyad Filza
Taufan Taufan
Dwi Budhi Susanto
Yunus Oksikimbawan Tampubolon
Anak Agung Ngurah Nata Baskara
Aidil Akbar Nurshal
Fuad Dheni Mustofa
Annissa Rosfadilla
Rahadyan Magetsari
Tedjo Rukmoyo
author_sort Yudha Mathan Sakti
collection DOAJ
description Abstract Introduction Screw insertion during scoliosis surgery uses free-hand pedicle screw insertion methods. However, there is a wide variation in pedicle shapes, sizes, and morphometry, especially in scoliosis patients. CT scan pedicle measurements in main thoracic Lenke type 1 adolescent idiopathic scoliosis can help visualize this diversity. This study aimed to highlight the features of pedicle morphometry on the concave and convex sides, including pedicle diameter (width in axial and height in the sagittal plane), the depth to the anterior cortex, and Watanabe Pedicle classification in patients with main thoracic apex adolescent idiopathic scoliosis. Materials and methods This study was a cross-sectional observational study of Adolescent Idiopathic Scoliosis (AIS) patients whose apex in the main thoracic patient underwent deformity correction procedures. We used a three-dimensional CT scan to evaluate pedicle morphometry on the apex vertebrae, three consecutive vertebrae above and below the apex. Results A total of 6 patients with apex main thoracic AIS with 84 pedicles consisting of 42 pedicles from each concave and convex curve were analyzed. All of the samples were female, with the mean age at the procedure being 21.2 ± 5.56. The mean cobb angle was 62° ± 23°, with the main apex between VT8-VT10. The size of the pedicle was bigger from upper to lower vertebrae. The mean pedicle depth, pedicle width, and pedicle height for the concave side were 36.06 ± 4.31 mm, 3.91 ± 0.66 mm, and 9.16 ± 1.52 mm, respectively. Meanwhile, the convex side is 37.52 ± 1.84 mm, 5.20 ± 0.55 mm, and 11.05 ± 0.70 mm, respectively. We found a significant difference between the concave and convex sides for the pedicle width and height. The concave and convex sides were mainly classified as type C (38%) and type A (50%) Watanabe pedicle. Conclusion Pedicle width and pedicle height are significantly different between the concave and the convex side with convex side has better Watanabe pedicle classification. Pre-operative CT evaluation is essential for planning proper pedicle screw placement in AIS patients.
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spelling doaj.art-f807b16093154d53bce3b824dea47d6a2023-02-12T12:03:28ZengBMCBMC Surgery1471-24822023-02-012311710.1186/s12893-022-01877-5Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosisYudha Mathan Sakti0Zikrina Abyanti Lanodiyu1Mahardhika Ichsantyaridha2Sonny Wijanarko3Muhammad Riyad Filza4Taufan Taufan5Dwi Budhi Susanto6Yunus Oksikimbawan Tampubolon7Anak Agung Ngurah Nata Baskara8Aidil Akbar Nurshal9Fuad Dheni Mustofa10Annissa Rosfadilla11Rahadyan Magetsari12Tedjo Rukmoyo13Orthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityOrthopedic and Traumatology Department, Sardjito General Hospital/Gadjah Mada UniversityAbstract Introduction Screw insertion during scoliosis surgery uses free-hand pedicle screw insertion methods. However, there is a wide variation in pedicle shapes, sizes, and morphometry, especially in scoliosis patients. CT scan pedicle measurements in main thoracic Lenke type 1 adolescent idiopathic scoliosis can help visualize this diversity. This study aimed to highlight the features of pedicle morphometry on the concave and convex sides, including pedicle diameter (width in axial and height in the sagittal plane), the depth to the anterior cortex, and Watanabe Pedicle classification in patients with main thoracic apex adolescent idiopathic scoliosis. Materials and methods This study was a cross-sectional observational study of Adolescent Idiopathic Scoliosis (AIS) patients whose apex in the main thoracic patient underwent deformity correction procedures. We used a three-dimensional CT scan to evaluate pedicle morphometry on the apex vertebrae, three consecutive vertebrae above and below the apex. Results A total of 6 patients with apex main thoracic AIS with 84 pedicles consisting of 42 pedicles from each concave and convex curve were analyzed. All of the samples were female, with the mean age at the procedure being 21.2 ± 5.56. The mean cobb angle was 62° ± 23°, with the main apex between VT8-VT10. The size of the pedicle was bigger from upper to lower vertebrae. The mean pedicle depth, pedicle width, and pedicle height for the concave side were 36.06 ± 4.31 mm, 3.91 ± 0.66 mm, and 9.16 ± 1.52 mm, respectively. Meanwhile, the convex side is 37.52 ± 1.84 mm, 5.20 ± 0.55 mm, and 11.05 ± 0.70 mm, respectively. We found a significant difference between the concave and convex sides for the pedicle width and height. The concave and convex sides were mainly classified as type C (38%) and type A (50%) Watanabe pedicle. Conclusion Pedicle width and pedicle height are significantly different between the concave and the convex side with convex side has better Watanabe pedicle classification. Pre-operative CT evaluation is essential for planning proper pedicle screw placement in AIS patients.https://doi.org/10.1186/s12893-022-01877-5Pedicle morphometryMorphologyCT scanAdolescent idiopathic scoliosisMain thoracic apex
spellingShingle Yudha Mathan Sakti
Zikrina Abyanti Lanodiyu
Mahardhika Ichsantyaridha
Sonny Wijanarko
Muhammad Riyad Filza
Taufan Taufan
Dwi Budhi Susanto
Yunus Oksikimbawan Tampubolon
Anak Agung Ngurah Nata Baskara
Aidil Akbar Nurshal
Fuad Dheni Mustofa
Annissa Rosfadilla
Rahadyan Magetsari
Tedjo Rukmoyo
Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
BMC Surgery
Pedicle morphometry
Morphology
CT scan
Adolescent idiopathic scoliosis
Main thoracic apex
title Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
title_full Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
title_fullStr Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
title_full_unstemmed Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
title_short Pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
title_sort pedicle morphometry analysis of main thoracic apex adolescent idiopathic scoliosis
topic Pedicle morphometry
Morphology
CT scan
Adolescent idiopathic scoliosis
Main thoracic apex
url https://doi.org/10.1186/s12893-022-01877-5
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