Document Detail

Anatomic relations between the lumbar pedicle and the adjacent neural structures.
MedLine Citation:
PMID:  9355213     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: The authors analyzed anatomic parameters between the lumbar pedicles and the dural sac as well as the spinal nerve roots. OBJECTIVES: To determine quantitatively the anatomic relations between the lumbar pedicle and adjacent dural sac and nerve roots. SUMMARY OF BACKGROUND DATA: Posterior transpedicular screw fixation is the most commonly used method of instrumentation for stabilization of the unstable lumbar spine. A thorough knowledge of the unique anatomy of the lumbar pedicle and adjacent neural structures may avoid or minimize neurologic complications with pedicular screw placement. METHODS: Fifteen adult cadavers were obtained to evaluate quantitatively the anatomic relations of the lumbar pedicle to the adjacent neural structures. After removal of the laminas and facets, the lumbar pedicles, dural sac, and nerve roots were exposed. Direct measurements were taken from the pedicle to the dural sac medially, to the nerve roots superiorly and inferiorly, and between the pedicles. Also, the superoinferior diameter of the nerve root and the frontal angle of the nerve root were measured. Symmetric structures were measured bilaterally. RESULTS: No consistent changes from L1 to L5 were found in all parameters. The mean distances from the lumbar pedicle to the dural sac medially and to the adjacent nerve roots superiorly and inferiorly for all levels were 1.5 mm, 5.3 mm, and 1.5 mm, respectively. The mean interpedicular distance ranged from 23.2 to 24.4 mm. The mean superoinferior diameter of the nerve root ranged from 3.8 to 4.6 mm. The mean nerve root angle ranged from 33.7 degrees to 39.2 degrees. CONCLUSIONS: On the basis of this study, improper placement of the pedicle screw medially or caudally in the lumbar spine should be avoided.
N A Ebraheim; R Xu; M Darwich; R A Yeasting
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  22     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-12-10     Completed Date:  1997-12-10     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2338-41     Citation Subset:  IM    
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
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MeSH Terms
Bone Screws*
Dura Mater / anatomy & histology*
Lumbar Vertebrae / innervation*,  surgery
Middle Aged
Spinal Nerve Roots / anatomy & histology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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