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Anatomical considerations of safe drilling corridor upper sacral segment screw insertion.

ABSTRACT: The upper segment of sacrum is an important for screw insertions of unstable lumbosacral spine. Measurements of the S1-S2 as sacral wings, pedicles, sacral foraminas and sacral canal were taken from 87 sacrums. The mean depths of S1 pedicle and sacral wing were estimated as 25.8?±?2.3?mm and 50.1?±?1.7?mm, respectively. Angles screw trajectory of sacral pedicle anteromedial and sacral wing were measured as 29.6?±?0.9° and 29.7?±?2.1°, respectively. To avoid injury to the vascular structures anteriorly and nerve roots medially, depth and angle of screw trajectory is important for the entrance off pedicular screw placement to the S1.

SUBMITTER: Bagheri H

PROVIDER: S-EPMC6806658 | biostudies-literature | 2019 Nov-Dec

REPOSITORIES: biostudies-literature

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Anatomical considerations of safe drilling corridor upper sacral segment screw insertion.

Bagheri Hassan H Govsa Figen F

Journal of orthopaedics 20190503 6

The upper segment of sacrum is an important for screw insertions of unstable lumbosacral spine. Measurements of the S1-S2 as sacral wings, pedicles, sacral foraminas and sacral canal were taken from 87 sacrums. The mean depths of S1 pedicle and sacral wing were estimated as 25.8 ± 2.3 mm and 50.1 ± 1.7 mm, respectively. Angles screw trajectory of sacral pedicle anteromedial and sacral wing were measured as 29.6 ± 0.9° and 29.7 ± 2.1°, respectively. To avoid injury to the vascular structures ante ...[more]

PMID: 31660021

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Project description:PurposeTo assess the effects of age and refractive status on anterior segment anatomical structures, including the ciliary body, using a new swept-source anterior segment optical coherence tomography (AS-OCT) device.MethodsThis prospective observational study included 63 healthy volunteers (mean age: 44.2 years). Images of the anterior segment were obtained using a new swept-source AS-OCT (ANTERION, Heidelberg Engineering GmbH, Heidelberg, Germany) with tracking and image averaging from the right eye of all participants. Repeatability as well as inter- and intra-observer reliability of biometric measurements were evaluated. The impact of image tracking and averaging on ciliary muscle measurements was tested. Univariate and multivariable statistical models were developed to evaluate the relationship of age and refractive status on anterior segment biometric measurements.ResultsFor all test-retest repeatability and inter- and intra-observer reproducibility of swept-source AS-OCT measurements, high intraclass correlation (ICC) was noted (0.88-1.00). The nasal maximum ciliary muscle thickness (CMTMAX) and distance between scleral spur to the thickest point of the ciliary muscle (SSMAX) were larger than those on the temporal side (p<0.001 and p = 0.006, respectively). Nasal and temporal CMTMAX (p = 0.004 and p<0.001, respectively) and lens thickness (p<0.01) increased with age. Nasal and temporal SSMAX decreased with older age and increasing hyperopia (p = 0.01 and p<0.001, respectively). Image averaging resulted in improved ciliary muscle measurements (p = 0.008 to 0.02). Lens vault increased with older age and increased hyperopia (p<0.01). OCT measurements of the angle decreased with older age and increased hyperopia (p<0.001 to 0.03). Aqueous depth decreased with older age and increased hyperopia (p<0.01). Pupil diameter decreased with older age (p<0.01).ConclusionsRepeatability and reproducibility of biometric measurements using the ANTERION AS-OCT were excellent. Image averaging improved the accuracy of ciliary muscle measurements. The device produced measurements of biometric parameters that described superficial and deep structures including the ciliary body and full lens thickness from a single image.

Dataset Information

Anatomical considerations of safe drilling corridor upper sacral segment screw insertion.

Publications

Anatomical considerations of safe drilling corridor upper sacral segment screw insertion.

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