The widths of the medial and lateral pedicle walls in adolescent idiopathic scoliosis with major thoracic curves

• Published in: The spine journal 2024-07, Vol.24 (7), p.1293-1301
• Main Authors: Chiu, Chee Kidd, Wang, Wee Jieh, Lee, Yu Jie, Chung, Weng Hong, Chan, Chris Yin Wei, Kwan, Mun Keong
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent idiopathic scoliosis; Child; CT scan; Female; Humans; Lateral pedicle wall; Male; Medial pedicle wall, Vertebral morphometry; Retrospective Studies; Scoliosis - diagnostic imaging; Scoliosis - pathology; Thoracic Vertebrae - diagnostic imaging; Young Adult
• ISSN: 1529-9430; 1878-1632; 1878-1632
• DOI: 10.1016/j.spinee.2024.02.014

The widths of medial and lateral pedicle walls in the normal spine of middle-aged and elderly adults have been investigated and these studies found that the medial pedicle wall was thicker than the lateral pedicle wall. However, none had evaluated the widths of medial and lateral pedicle walls on adolescent or young adult scoliotic spines. This study aims to identify the distribution and variation of medial and lateral pedicle wall widths throughout the different vertebral levels of the scoliotic spine and its differences according to age, gender, body mass index (BMI), maturity, curve types and curve severity in adolescent idiopathic scoliotic (AIS) patients with major thoracic curves. Retrospective study. A total of 6,230 pedicles (right: 3,064, left: 3,166) from 191 patients were included in this study, with 264 (right: 183, left: 81) fully corticalized pedicles excluded from analysis. Demographic data were age, gender, height, weight, BMI, Risser grade, Lenke curve types and Cobb angles. The main outcome measures were medial and lateral pedicle wall widths. Associations between pedicle wall widths and demographic data were calculated. This was a subanalytical retrospective study done on the same patient population as the previously published study on pedicle grading. The data was obtained from the main computed tomography (CT) scan pedicle study dataset. Medial and lateral pedicle wall widths were measured in the axial slices of CT scans from T1 to L5 vertebrae. A total of 6,230 pedicles (right: 3,064, left: 3,166) from 191 patients were included in this study with 264 (right: 183, left: 81) fully corticalized pedicles excluded from analysis. Right-sided medial pedicle wall widths were narrower from T4–T10 (0.75±0.23 mm) compared to T1–T3 (0.89±0.28 mm) and T11–L5 (0.92±0.30 mm). Left-sided medial pedicle wall widths were narrower from T4 to T7 (0.76±0.24 mm) compared to T1–T3 (0.88±0.26 mm) and T8–L5 (0.90±0.27 mm). Medial cortical wall widths were significantly thicker compared to lateral cortical wall widths for all vertebras from T1 to L5 (right medial 0.85±0.28 mm vs lateral 0.64±0.26 mm (p