Online citations, reference lists, and bibliographies.
← Back to Search

Characteristics Of Regional Bone Quality In Cervical Vertebrae Considering BMD: Determining A Safe Trajectory For Cervical Pedicle Screw Fixation

Moonkyu Kim, Ho-Jung Cho, Dai-Soon Kwak, Seung-Hoon You
Published 2018 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
This study aimed to report the mechanical strength and characteristics of the lateral mass and pedicle considering BMD for the safe insertion of pedicle screws in the subaxial cervical level. We evaluated BMD and Hounsfield unit (HU) values of cortical bones at the lateral mass and pedicle of C3‐7 from CT images in 99 patients. Patients were divided into three groups (Group A, T‐score ≥ −1; Group B, −2.5 < T‐score < −1.0; Group C, T‐score ≤ −2.5). The HU numbers of cortical bone in the vertebral canal (medial wall of the lateral mass; cHU), posterior wall of the transverse foramen (fHU), and medial wall, lateral wall, and trabecular area of the pedicle (mHU, lHU, and pHU, respectively) were measured on the CT images in the middle of the pedicle. A mechanical study was also performed to measure cortical bone strength using 10 fresh cadavers. The cHU and mHU values in Group C were higher than lHU and fHU in Groups A and B, and there was a wide gap between the pHU value and other areas. The penetrating force also had a close correlation with HU number. The mean penetrating force of the medial wall of the lateral mass and the posterior wall of the transverse foramen were 210.08 ± 110.46 and 50.51 ± 46.09 N, respectively. The cortical bones in the vertebral canal and medial wall of the pedicle were stronger than the lateral wall and the trabecular area. The cHU and mHU in the osteoporotic group were higher than fHU and pHU in the normal group. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:217–223, 2018.
This paper references
Free Hand Pedicle Screw Placement in the Thoracic Spine: Is it Safe?
Y. Kim (2004)
Biomechanical Analysis of Transpedicular Screw Fixation in the Subaxial Cervical Spine
R. Kothe (2004)
Morphologic Characteristics of Human Cervical Pedicles
E. Karaikovic (1997)
Accuracy of Cervical Pedicle Screw Placement Using the Funnel Technique
E. Karaikovic (2001)
Estimation of mechanical properties of cortical bone by computed tomography
S. Snyder (1991)
Computed Tomography, 3rd ed: Elsevier; 560 p
E. Seeram (2008)
Computed tomographic morphometric analysis of cervical pedicles in a multi-ethnic Asian population and relevance to subaxial cervical pedicle screw fixation
T. Munusamy (2014)
Cervical pedicle screw placement: feasibility and accuracy of two new insertion techniques based on morphometric data
M. Reinhold (2006)
Hounsfield units for assessing bone mineral density and strength: a tool for osteoporosis management.
J. J. Schreiber (2011)
Cervical Pedicle Screw Insertion Using the Technique with Direct Exposure of the Pedicle by Laminoforaminotomy
Dae-Jean Jo (2012)
Cervical Pedicle Screws Versus Lateral Mass Screws: Anatomic Feasibility and Biomechanical Comparison
E. Jones (1997)
Opportunistic Screening for Osteoporosis Using Abdominal Computed Tomography Scans Obtained for Other Indications
Perry J. Pickhardt (2013)
Anatomical considerations for cervical pedicle screw insertion: the use of multiplanar computerized tomography reconstruction measurements.
M. Chazono (2006)
The medial cortical pedicle screw--a new technique for cervical pedicle screw placement with partial drilling of medial cortex.
B. Mahesh (2014)
The Safety and Accuracy of Freehand Pedicle Screw Placement in the Subaxial Cervical Spine: A Series of 45 Consecutive Patients
J. Park (2014)
Computed tomography assessment of lateral pedicle wall perforation by free-hand subaxial cervical pedicle screw placement
Yingsong Wang (2013)
Morphological Analysis of the Cervical Pedicles, Lateral Masses, and Laminae in Developmental Canal Stenosis
Masashi Miyazaki (2010)
Predicting ex vivo failure loads in human metatarsals using bone strength indices derived from volumetric quantitative computed tomography.
D. Gutekunst (2013)
Subaxial cervical pedicle screw insertion with newly defined entry point and trajectory: accuracy evaluation in cadavers
Xiujun Zheng (2009)
Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry.
J. Schousboe (2013)
Biomechanical Study of Screws in the Lateral Masses: Variables Affecting Pull-out Resistance*
J. Heller (1996)
Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope
Y. Yukawa (2009)
A Novel Method of Cervical Pedicle Screw Placement From C3 to C5 and Its Clinical Applications
Jing-chen Liu (2013)
Anatomic relation between the cervical pedicle and the adjacent neural structures.
R. Xu (1997)
Reconstruction of the Subaxial Cervical Spine Using Pedicle Screw Instrumentation
K. Abumi (2012)
Cervical pedicle screw insertion using a gutter entry point at the transitional area between the lateral mass and lamina
K. Tofuku (2011)
CT Morphometric Analysis to Determine the Anatomical Basis for the Use of Transpedicular Screws during Reconstruction and Fixations of Anterior Cervical Vertebrae
C. Chen (2013)
combination of miniopen surgery and use of a percutaneous cannula system-pilot study
MK Kim (1976)
Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone 17 This article is protected by copyright. All rights reserved densitometry
JT Schousboe (2013)
Analysis of Cervical Pedicle With Reconstructed Computed Tomography Imaging in Korean Population: Feasibility and Surgical Anatomy
Soo-Hoon Oh (2014)
Internal morphology of human cervical pedicles.
M. Panjabi (2000)
Complications of Pedicle Screw Fixation in Reconstructive Surgery of the Cervical Spine
K. Abumi (2000)
Cervical Human Vertebrae Quantitative Three‐Dimensional Anatomy of the Middle and Lower Regions
M. Panjabi (1991)
Differences in bone mineral density of fixation points between lumbar cortical and traditional pedicle screws.
Harry Mai (2016)
Correlation between Bone Mineral Density Measured by Dual-Energy X-Ray Absorptiometry and Hounsfield Units Measured by Diagnostic CT in Lumbar Spine
S. Lee (2013)
Opportunistic screening for osteoporosis by routine CT in Southern Europe
Elena Alacreu (2016)
The Learning Curve of Pedicle Screw Placement: How Many Screws Are Enough?
A. Gonzalvo (2009)
Incorporating uncertainty in mechanical properties for finite element-based evaluation of bone mechanics.
P. Laz (2007)
Computed tomography, 3rd ed
E. Seeram (2008)
Clinical accuracy of cervical pedicle screw insertion using lateral fluoroscopy: a radiographic analysis of the learning curve
H. Yoshimoto (2009)
Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review.
H. Yoshihara (2013)
Hybrid Technique for Cervical Pedicle Screw Placement: Combination of Miniopen Surgery and Use of a Percutaneous Cannula System—Pilot Study
Moonkyu Kim (2015)

This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar