Radiologische Evaluation der anatomischen Möglichkeit zur Implantation von Pedikelschrauben im Bereich des kraniozervikalen Übergangs sowie der oberen Halswirbelsäule

by Lina Wübbeke
Doctoral thesis
Date of Examination:2023-09-05
Date of issue:2023-08-21
Advisor:PD Dr. Lukas Weiser
Referee:PD Dr. Lukas Weiser
Referee:PD Dr. Florian Freimann
Persistent Address: http://dx.doi.org/10.53846/goediss-10020

 

 

Files in this item

Name:Dissertation_ Wübbeke_Online.pdf
Size:5.12Mb
Format:PDF

The following license files are associated with this item:

Abstract

English

Instabilities of the craniocervical junction and the upper cervical spine may require dorsal stabilization of the spine to prevent neurological complications. We aimed to analyze the number of patients in which pedicle screw placement would be possible from an anatomical point of view to determine the clinical value of this kind of screw placement. This retrospective data analysis included 210 patients who underwent a CT scan of the cervical spine at the University Hospital Göttingen (UMG). Pedicle height and width of the first cervical vertebra and of the third to fifth cervical vertebra were measured bilaterally and in a standardized manner. The primary endpoint was a pedicle height and width greater than 4 mm. In addition, sex-specific and age-specific differences in pedicle height and width were analyzed as secondary endpoints. On the right side, pedicle height of the first cervical vertebral body was greater than 4 mm in 55.2% of the patients (4.10 mm ± 0.94) and on the left side in 46.7% (3.91 mm ± 0.97). In case of the third to fifth cervical vertebral bodies, both pedicle height and pedicle width were greater than 4 mm in most patients (77.1% to 100%). A significant gender difference in the pedicle height of the first cervical vertebral body was found, as in the female patients the required pedicle height of more than 4 mm was achieved in only 39.5% and 29.1% of the cases, respectively. Age-specific differences were not found. The results suggest that the pedicle height of the first cervical vertebral body is the limiting factor, which would allow pedicle screw placement averaged in every second patient. A significant gender-specific difference in pedicle height of the first cervical vertebral body to the disadvantage of female patients has to be considered in preoperative preparation and planning.
Keywords: dorsal stabilization; upper cervical spine; pedicle screw placement
 
Statistik