Objective To provide theoretical basis for the design of new double threaded pedicle screws, by measuring the anatomical parameters of cervical vertebrae in normal people. Methods A total of 100 healthy individuals were collected and the cervical spine CT scan were completed. The length of bilateral pedicle screw insertion path (including intra-vertebral length, pedicle length, and vertebral plate length, as reference for pedicle screw length design), insertion abduction angle, and width and height of pedicle isthmus (as reference for pedicle screw diameter design) of C3~7 on CT scan. The mean value and quartile of each measurement result were calculated. Results Basic information of 100 adult healthy volunteers, including height, age, weight, and comorbidities, including 54 males and 46 females, with an average age of 35.95 years were recorded. From the CT scan of C3~7, there was no statistical difference between the left and right sides of each parameter (P>0.05). There was no statistical difference in male and female (P>0.05). The average length of the vertebral body in the lower cervical pedicle screw insertion path was (15.85±1.20)~(19.40±1.50) mm. The average length of the pedicle was (5.42±1.06)~(6.03±0.84) mm. The average length of the vertebral lamina was (9.52±1.15)~(10.33±1.58) mm. The average range of nail insertion and abduction angle was (39.82±2.53) °~(42.56±2.50) °. The average width of the pedicle isthmus was (5.84±0.87)~(7.10±1.05) mm. The average height of the pedicle isthmus was (6.71±1.10)~(8.26±1.22) mm. Conclusions The measurement of the anatomical parameters related to C3~C7 pedicle screw fixation in normal people provides theoretical basis for the design of a new type of double-threaded pedicle screw.
Key words
Lower cervical vertebra;  /
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Anatomical measurement;  /
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Double- threaded pedicle screw
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References
[1] Hachan S, Bin Abd Razak HR, Loo WL, et al. Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation[J]. Eur Spine, 2018, 27:2729-2736. DOI: 10.1007/s00586-018-5585-1.
[2] Kast E, Mohr K, Richter HP, et al. Complications of transpedicular screw fixation in the cervical spine[J]. Eur Spine, 2006, 15:327-334. DOI: 10.1007/s00586-004-0861-7.
[3] Kotani Y, Abumi K, Ito M, et al. Improved accuracy of computer-assisted cervical pedicle screw insertion [J]. Neurosurgery, 2003, 99(3 Suppl):257–263. DOI: 10.3171/spi.2003.99.3.0257.
[4] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique. [J] Spinal Disord,1994,7:222–229. DOI: 10.1097/00002517-199407030-00004.
[5] Jones EL, Heller JG, Silcox DH, et al. Cervical pedicle screws versus lateral mass screws. Anatomic feasibility and biomechanical comparison[J]. Spine (Phila Pa 1976), 1997, 22(9):977-982. DOI: 10.1097/00007632-199705010-00009
[6] Gelalis ID, Paschos NK, Pakos EE, et al. Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques[J]. Eur Spine,2012, 21:247-255. DOI: 10.1007/s00586-011-2011-3.
[7] Barrey C, Cotton F, Jund J, et al. Transpedicular screwing of the seventh cervical vertebra: anatomical considerations and surgical technique [J]. Surg Radiol Anat, 2003, 25(5,6):354-360. DOI: 10.1007/s00276-003-0163-5.
[8] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique [J]. Spinal Disord,1994,7(3):222-229. DOI: 10.1097/00002517-199407030-00004.
[9] Karami KJ, Buckenmeyer LE, Kiapour AM, et al. Biomechanical evaluation of the pedicle screw insertion depth effect on screw stability under cyclic loading and subsequent pullout[J]. Spinal Disord Tech, 2015, 28(3):E133-E139. DOI: 10.1097/BSD.0000000000000178.
[10] Ebraheim NA, Xu R, Knight T, et al. Morphometric evaluation of lower cervical pedicle and its projection [J]. Spine, 1997, 22(1):1-6. DOI: 10.1097/00007632-199701010-00001.
[11] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique[J]. Spinal Disord, 1994, 7(3):222-229. DOI: 10.1097/00002517-199407030-00004.
[12]康意军, 陈飞, 吕国华, 等. 颈椎椎弓根钉在强直性脊柱炎颈椎骨折 中的应用[J].中南大学学报(医学版), 2005, 30(6):700-703.
[13] Westermann L, Spemes C, Eysel P, et al. Computer tomography-based morphometric analysis of the cervical spine pedicles C3-C7[J]. Acta Neurochir (Wien), 2018,160:863-871. DOI: 10.1007/s00701-018-3481-4.
[14]Chanplakorn P, Kraiwattanapong C, Aroonjarattham K, et al. Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation[J]. BMC Musculoskelet Disord, 2014, 15:125. DOI: 10.1186/1471-2474-15-125.
[15] Krenn MH, Piotrowski WP, Penzkofer R, et al. Influence of thread design on pedicle screw fixation. Laboratory investigation [J].Neurosurg Spine, 2008, 9(1):90-95. DOI: 10.3171/SPI/2008/9/7/090.