Study On Anatomic Relation Between The Cervical Pedicle And The Adjacent Neural Structure With The Radiologic Anatomy Of The Pedicles

Objective: The primary purpose of the current study is to avoid and minimize the complication in performing the technique, by providing accurate quantitative anatomic data of the relation of the cervical spine to the adjacent neural structure and describing the pedicle image in the roentgenogram.Methods: 15 cadavers were used for dissection to observe the relations of the cervical spine to the adjacent neural structure. After removal of whole posterior bony element of the cervical spine, the isthmus of the pedicles, the nerve roots of C3-C7 and the dural sac were exposed. The parameters of the cervical pedicles and the distance between the pedicle and the adjacent structure were measured directly. In addition, 6 fresh-bone cervical spine specimens were prepared and the isthmus of the pedicle were drawn tightly with radiopaque fine malleable wire, the cervical spine were then imaged to determine the correlation between the pedicle cortex and the radiologic image. Results: In 15 cadavers, PDSD: 0-6.2mm0 PSRD Nt: 0-2.9mm, PSRD Ft: 2.72-9.60mnio PIRD Nt: 0-4.1mm, PIRD Ft: 0.96-5.73mm0 PH: 4.5-8.2mm, PW:3.6-6.7mm0 IPD: 21.0-25.4mm, DSW: 13.5-18.3mmo REA: 39?102? OPAA: -12-44. In the roentgenogram, 1): the image of the pedicle is an oblique tube structure lateral to the cervical vertebrate in the PA radiograph; the long axis of C5-7 pedicle ellipse is oblique to the vertical. 2): The pedicle image isn't shown directly in lateral radiograph, the intensive density area made by the overlapping pedicles is superior on the posterior wall of the vertebrate. 3): Four lateral cortex border and the shape of the cervical pedicle are demonstrated clearly in the oblique radiograph, theradiologic pedicle image is consistent within the true bony cortex of the pedicle. Conclusion: There are some difference in the distances between the cervical pedicle and the adjacent neural structure more frequently. This study indicates the placement of the pedicle screw medially and superiorly in the middle and lower cervical pedicle is proper o About the roentgenogram, the radiologic pedicle image in the cervical spine is a reliable guide to the true bony cortex of the pedicle. The coaxial image of the pedicles is well correlated with the oblique radiograph of the cervical spine, it is a very useful to grasp the feature of every pedicle accepting the transpedicular screw as well as the PA radiograph. The lateral fluoroscopic assistance for transpedicular fixation in the cervical spine needs to be re-evaluated.