MEASUREMENT OF SAGITTAL INCLINATION OF THE LUMBAR VERTEBRAE AT PRONE POSITION
Journal Title: Journal of Turkish Spinal Surgery - Year 2004, Vol 15, Issue 1
Abstract
Objective: Transpedicular screws are widely used in spinal instrumentation, however many complications could be seen during this procedure. Anatomical landmarks, entry points and proper screw inclination in transverse and sagittal planes are important points during transpedicular screw application. Besides the orientation of pedicle in sagittal plane, motions of the vertebra in sagittal plane may have an effect on direction and position of screw. In this study, sagittal inclination of lumbar vertebra in prone position is investigated. Methods: Right lateral decubitus position (DP) and prone position (PP) radiographs are obtained from 30 volunteers (average age 29 years old) without low back complaint. The position of the patient during the radiographs is similar to the prone position during surgery which is routinely used in our clinic. Longitudinal pillows with a diameter of 18 cm are placed under the chest and abdomen extending from axilla to the iliac crest. Sagittal plan inclination (SPI) of each vertebra are measured manually on both radiographs. Values are analyzed statistically with paired t test. Results: SPI of the L1 vertebra at DP and PP position are measured as +19.8 and 14.3 respectively (p=0.000). SPI of the L2 vertebra are measured as +16.0 at DP position and +13.1 at PP position (p=0.017). There are no statistically significant difference between groups of L3, L4 and L5 level (respectively p=0.973, p=0.056 and p=0.071). There is statistically significant difference in lumbar lordosis between two groups (p=0.000). Discussion: Lumbar vertebrae have greater range of motion at sagittal plane. According to our results upper lumbar vertebrae (L1-L2) have significant movement when the patient’s position DP is changed to PP. During the application of transpedicular screw fixation at upper lumbar vertebrae (L1-L2) radiological evaluation of the sagittal alignment of the upper lumbar segments at prone position may contribute to the proper insertion of the screw.
Authors and Affiliations
A. Esat KITER ,Fahir DEMIRKAN, B. Alper KILIÇ, Gürkan ERKULA, Ertan ER
Keywords
Related Articles
- EP ID EP676475
- DOI -
- Views 114
- Downloads 0
NEW CLASSIFICA TION OF THORACOLUMBAR SPINE FRACTURES
Although numerous systems have been proposed, there is no universally accepted classification or scoring system for thoracolumbar spine injuries. Contemporary understanding of the biomechanics, natural history, and metho...
SURGICAL TREATMENT OF BURST FRACTURES OF THE LUMBAR SPINE
Surgical treatment has been performed for 21 cases of burst fractures of the lumbar spine between the years 1990 and 1993. Cases had different fracture levels varying between L2 and L4 and Farcy's criteria were used for...
DRUMMOND INSTRUMENTATION IN THE SURGICAL TREATMENT OF IDIOPATHIC SCOLIOSIS
Harrington instrumentation has been extensively employed world-wide in the surgical treatment of idiopathic scoliosis for 25 years. This procedure seems to be disadvantageous in that it has no corrective effect on tho...
ASSESSMENT OF SPINAL IMPLANTS UNDER CYCLIC LOADING
An experimental technique is developed to study the transfer of load through spinal Instruments when subjected to cyclic loading. İn this study two series of tests are conducted on in vitro calf spines comprising of thre...
MORPHOMETRIC ANALYSIS OF THORACOLUMBAR SPINE
In the spine surgery, each vertebrae in the thoracolumbar region has to be notably analysed as a separate region because of their common anatomical and morphometric features. Especially being a biomechanically transition...