A study of the sagittal angle of lumbar bicortical pedicle screws from the anatomical perspective of the lumbar artery.

A study of the sagittal angle of lumbar bicortical pedicle screws from the anatomical perspective of the lumbar artery.

World Neurosurg. 2019 Jan 29;:

Authors: Liu L, Wang H, Wang Q, Wang J, Liang Y, Li Y, Liang Q, Jin W, Zhou Q, Wang Z

Abstract
OBJECTIVE: Observing the anatomical relationships between lumbar bicortical pedicle screws (BPSs) at two sagittal section angles (SSAs) and the lumbar artery (LA).
METHODS: We observed two SSAs of the BPS, namely, the vertical angle and cephalic angle. Correspondingly, the positions at which the BPS breaks through the anterior vertebral cortex were defined as Point A and Point B. The distances from Point A and Point B to the LAs were measured and denoted DA-LA and DB-LA. According to these distances, the percentage of risk of injury to the LAs was calculated.
RESULTS: At the same transverse section angle (TSA) on the left and right side in L1 and L2, the DA-LA was significantly greater than the DB-LA (P < 0.001), except at a TSA of 0° on the right side in L2 (P > 0.05). At the same TSA on the left in L3 and L4, the DB-LA was significantly greater than the DA-LA (P < 0.001). The percentages of high risk of injury to the LA resulting from BPS at the vertical angle in L1 and L2 ranged from 0% to 6.2%. The percentages of high risk of injury to the LA resulting from BPS at the cephalic angle on the left side in L3 and L4 ranged from 0% to 18.5%.
CONCLUSION: Lumbar BPSs present a risk of injury to the LA. The vertical angle is the recommended SSA for the BPSs in L1 and L2, and the cephalic angle is the recommended SSA in L3 and L4.

PMID: 30708080 [PubMed - as supplied by publisher]

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