Study Of Thoracic Pedicle Morphology In Idiopathic Scoliosis With 16 Multi-Slice Spiral CT And Multiplanar Reformation

Background: Several studies have provided data on the vertebral morphology of normal spines, but there is a paucity of data on the vertebral morphology in patients with idiopathic scoliosis. We Study thoracic pedicle morphology in idiopathic scoliosis with 16 multi-slice spiral ct and multiplanar reformation. Methods: The morphology of the pedicles of 392 vertebrae in eighteen with right-sided thoracic idiopathic scoliosis were analyzed with use of 16 multi-slice spiral ct and multiplanar reformation. Results: A distinct pedicle asymmetry was found at the apical region of the thoracic curves, with significantly thinner pedicles on the concave side than on the convex side. The degree of intravertebral deformity diminished farther away from the apex, with vertebral symmetry restored at the neutral level. In the thoracic spine, the transverse endosteal width of pedicles measured between 1.3 mm and 5.3 mm on the concave side. The pedicle depth and the pedicle length gradually increased from 29 mm and 16 mm to 45 mm and 23 mm, respectively. The transverse pedicle angle measured 29 deg in the cephalad aspect of the thoracic spine, decreased to 2.8 deg at the twelfth thoracic vertebra. Conclusion: Idiopathic scoliosis is associated with distinctive intravertebral deformity, with smaller pedicles on the concave side.Care must be exercised during pedicle-screw instrumentation, especially in the apical region of the concavity of thoracic curves, because of the small pedicle width in this area. Surgeons should be aware of these altered conditions when considering pedicle-screw instrumentation for patients with thoracic scoliosis.