To Study Anatomy And Clinical Significance Of Transpedicular Basilar Part Puncturing Approach

Objective: To study the unipedicular approach meeting therequirement of injection of cement or not as well as the possibility andsafety of transpedicular basilar part puncturing approach.Methods: Twelve human adult spines (T₄～L₅) were gathered frompreservative cadavers. Computerized Tomography(CT)was used forscanning from T₄ to L₅. The pedicle was divided into basilar section, isthmussection and costal process section in the transverse sections. The width ofpedicular basilar part and pedicle isthmus, angles of pedicular basilar partas well as the successful percentage of the 3mm diameter puncture needlevia transpedicular approach toward the centre of mid-anterior 1/3 part(target point) of the vertebral body were measured in the transversesections. The sagittal angles of the track of transpedicular basilar partapproach to the target point were observed and measured.Results: The angles of the pedicle basilar part diminished from T₄ toT₈ and enlarged from T₉ to L₅.The width of the pedicle basilar part enlargedfrom T₄～L₅. The successful percentage of the 3mm diameter punctureneedle via transpedicular approach toward the target point was: L₄ and L₅ were 100%, T₁₁ was 17%, T₁₂ was 25%. There were no significantdifferences of these parameters between male and female groups orbetween left and right sides.Conclusion: When pedicle is narrow, the unipedicular approach doesnot meet the requirement of percutaneous vertebroplasty, but transpedicularbasilar part approach meets the requirement of each thoracolumbar and isquite safe.