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Anatomical differences in the bony structure of L5 and L4: A possible classification according to the lateral tilt of the pedicles

Publication date: March 2018 Source:Journal of Orthopaedics, Volume 15, Issue 1 Author(s): Giorgio Cacciola, Giuseppe Anastasi, Salvatore Bertino, Giuseppina Rizzo, Giuseppina Cutroneo, Fabio Trimarchi, Alessandro Pisani, Pietro Cavaliere, Andrea Barbanera, Daniele Bruschetta The aim of this study is to underline the necessity of a better knowledge of pedicles anatomy in order to improve surgical treatment of spine disorders such us low back pain, spinal fractures and scholiosis. A classification of pedicles lateral tilt which could help surgeons before the application of screws during transpedicular fixation is reported. Anatomical differences in the orientiation of the pedicles of L5 and L4 have been found. For each patient that met the inclusion criteria underwent: Radiography of the lumbo-sacral region, CT examination, MRI acquisition. Patients were divided into three categories thanks to 3D direct volume rendering of CT scan. Subjects belonged to W-Type, V-Type and U-type depending on their morphometric features. The subdivision was further implemented with measurements of the distance between pedicles and adjacent nervous structures. Concerning L5, W-Type (WT) exhibited a lateral tilt of L5 larger than 36°, V-Type exhibited a lateral tilt of L5 from 30° to 36°, U-type exhibited a lateral tilt of L5 smaller than 30°. Concerning L4, WT exhibited a lateral tilt of 28.4°, VT exhibited a lateral tilt of of 25.1, UT exhibited a lateral tilt of 22.2°; ...
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research

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