Objective To study the anatomical basis of the percutaneous pedicle screw fixation technique in transverse process root approach and analyze the feasibility of the screw placement method. Methods In this study, 3D CT reconstruction images of 100 adult lumbar spine from L1 to L5 were analyzed by using the PACS system. The imaging anatomical parameters of the screw cross section, including the insertion angle, width of the pedicle, length of the ideal screw tract and length of the ideal screw tract within the pedicle were measured. Results There was no statistical difference between the left and right sides of the same vertebral level (P>0.05). Additionally, there was no significant difference in angle measurements between different genders (P>0.05). However, there were significant differences in most length indicators between genders (P<0.05), with males having larger measurements compared with females. The minimum inner inclination angles from L1 to L5 were as follows: 15.40°, 16.63°, 14.74°, 11.82°, and 6.82°, respectively. The maximum inner inclination angles were: 36.22°, 38.86°, 42.99°, 49.05°, and 54.70°, respectively. The ideal inclination angles were: 23.67°, 24.30°, 25.08°, 27.10°, and 29.96°, respectively, exceeded the internal inclination angle of the traditional insertion point and fell within a safe range of 20.83° to 47.88°. In the cross-section where the screw placed, the average pedicle width from L1 to L5 in males was: 6.82, 6.96, 8.38, 10.31 and 13.65 mm, while in females it was: 5.39, 5.78, 7.24, 9.09 and 13.21 mm. The length of the ideal screw tract in males was: 54.90, 55.19, 55.75, 54.87 and 56.27 mm, whereas in females it was: 51.04, 51.31, 52.68, 52.11 and 54.71 mm. The length of the ideal screw tract within the pedicle in males was: 20.85, 19.87, 18.41 mm, 15.87 and 15.02 mm, while in females it was: 20.18, 19.02, 17.00, 15.19 and 15.05 mm. Conclusions The imaging results indicate that the transverse process root approach at a specific anatomical location is a safe and reliable insertion point for pedicle screws. This finding provides new reference for selecting the appropriate insertion point of pedicle screws in percutaneous pedicle screw techniques.
Key words
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Lumbar vertebra /
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Insertion point /
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Pedicle screw /
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Imaging anatomy
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