Chiu, Chee Kidd and Wang, Wee Jieh and Lee, Yu Jie and Chung, Weng Hong and Chan, Chris Yin Wei and Kwan, Mun Keong (2023) What is the prevalence and distribution of narrow dysplastic and fully corticalized pedicles in Asian adolescent idiopathic scoliosis patients with major main thoracic curves? A computed tomography scan analysis of 6,494 pedicles. Spine Journal, 23 (11). pp. 1700-1708. ISSN 1529-9430, DOI https://doi.org/10.1016/j.spinee.2023.07.006.
Full text not available from this repository.Abstract
BACKGROUND CONTEXT: Patients with adolescent idiopathic scoliosis (AIS) have higher prevalence of abnormal or dysplastic pedicles.PURPOSE: To investigate the prevalence and distribution of narrow dysplastic and fully corticalized pedicles in Asian AIS patients with major main thoracic curves.DESIGN: Retrospective study.PATIENT SAMPLE: A total of 6,494 pedicles in 191 patients were measured and evaluated.OUTCOME MEASURES: The primary outcomes measures were the pedicle width measurements (total transverse pedicle width, transverse cancellous width, total transverse cortical width) and classification of pedicles. Demographic data (age, gender, height, weight, body mass index), proximal thoracic Cobb angle, main thoracic Cobb angle and lumbar Cobb angle were also obtained. METHODS: AIS patients with major (largest Cobb angle) main thoracic curves and had computed tomography (CT) scans prior to corrective spine surgery were reviewed. The pedicles were classified as Grade A: cancellous channel >4 mm; Grade B: cancellous channel 2 to 4 mm; Grade C: cancellous channel <2 mm or corticalized pedicle >4 mm; Grade D: corticalized pedicle <= 4 mm. Grades B, C, and D were dysplastic pedicles while grades C and D were narrow dysplastic pedicles.RESULTS: The prevalence of dysplastic pedicles (grades B, C, and D) was 61.7%. There were 22.6% narrow dysplastic pedicles (grades C and D) and 4.1% fully corticalized pedicles (grade D). In the thoracolumbar region, there was a sharp transition from larger and less dysplastic pedicles at T11 and T12 to narrower and more dysplastic pedicles at L1 and L2 (narrow dysplastic pedicles at T11: 3.1%, T12: 3.1%, L1: 39.8% and L2: 23.6%). Higher prevalences of narrow dysplastic pedicles were located at right T3 to T5 (71.2%-83.7%) and left T7-T9 (51.3%-61.2%). Higher prevalences of fully corticalized pedicles were located at right T3 to T5 (20.9%-34.0%) and left T7 to T8 (11.0%-12.0%). These were the concave pedicles of proximal thoracic and main thoracic curves, respectively.CONCLUSION: There were 95.9% pedicles with cancellous channels (grades A, B, and C) can allow pedicle screw fixation and only 4.1% fully corticalized pedicles (grade D) that require an alternative method of fixation. For grade C pedicles (18.5%), pedicle screws can still be attempted with caution. Precautions should also be observed at the L1 and L2 levels as there was a transition to narrower pedicles.(c) 2023 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Adolescent; Corticalized; Dysplastic; Idiopathic; Pedicles; Scoliosis |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Orthopaedic Surgery Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 09 Sep 2025 01:56 |
| Last Modified: | 09 Sep 2025 01:56 |
| URI: | http://eprints.um.edu.my/id/eprint/50607 |
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