MORPHOMETRY OF THE POSITIONING OF CORTICAL TRAJECTORY PEDICLE SCREWS IN BRAZILIANS

ABSTRACT Objective Morphometric study of the positioning of the cortical trajectory pedicle screw in the lumbar spine of Brazilian patients of different sexes and ages, through the use of computed tomography images, in order to obtain more reliable data about cortical screw insertion and the variations observed, providing assistance for a safer, more effective approach with fewer complications. Methods Selection of 100 patients from a database, alternating by sex, measuring the length, diameter, cephalic angulation, and lateral angulation of the vertebrae from L1 to L5. Results Statistically significant measurements were obtained for the four different parameters in relation to sex. The mean age was 56, with a minimum of 20 and a maximum of 87 years. The L4 and L5 screws showed a reduction in relation to the other levels, while the width showed a progressive increase starting at L3. Lateral angulation was the parameter with the least variation among the levels, while there was greater variation and a reduction from L4 to L5 in cephalic angulation. Conclusion Statistically significant results were obtained for length, diameter, lateral and cephalic angulation. Sex was a significant factor in spine surgery instrumentation using the cortical trajectory pedicle screw technique. Level of evidence I; Diagnostic study (investigation of an examination for diagnosis).

摘要 研究目的：通过计算机断层扫描（computed tomography）影像，对不同性别与年龄的巴西腰椎患者的皮质轨迹椎弓根螺钉（cortical trajectory pedicle screw）置入位置开展形态计量学研究，以期获取皮质螺钉置入操作及相关变异的更可靠数据，为实现更安全、高效且并发症更少的手术方案提供辅助依据。
研究方法：从数据库中筛选100例患者，按性别交替纳入研究对象，测量L1至L5椎体的螺钉置入长度、直径、头侧成角及侧方成角。
研究结果：针对四项测量参数，获得了与性别相关的具有统计学意义的测量数据。受试者平均年龄为56岁，年龄跨度为20~87岁。L4与L5节段的螺钉长度较其余节段更短，而螺钉直径自L3节段起呈渐进性递增趋势。侧方成角是各节段中变异程度最小的参数，头侧成角则存在较大变异，且自L4至L5节段呈逐渐降低的变化趋势。
研究结论：本研究在螺钉长度、直径、侧方成角及头侧成角四项参数中均获得了具有统计学意义的结果。性别是采用皮质轨迹椎弓根螺钉技术实施脊柱手术内固定时的重要影响因素。证据等级：I级；诊断性研究（针对诊断性检查的调查研究）。