The radiologic anatomy of the lumbar and lumbosacral pedicles

An anatomic and radiologic study of lumbar and lumbosacral pedicle anatomy. To define the radiologic anatomy of the lumbar and first sacral pedicle in the coaxial projection. Fluoroscopic assistance for pedicle screw placement requires radiologic landmarks. The radiologic landmarks have previously b...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2000-03, Vol.25 (6), p.709-715
Main Authors: ROBERTSON, P. A, STEWART, N. R
Format: Article
Language:English
Subjects:
Biological and medical sciences
Bone Screws
Bone Wires
Humans
In Vitro Techniques
Investigative techniques, diagnostic techniques (general aspects)
Lumbar Vertebrae - anatomy & histology
Lumbar Vertebrae - diagnostic imaging
Medical sciences
Osteoarticular system. Muscles
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiography
Reference Values
Sacrum - anatomy & histology
Sacrum - diagnostic imaging
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Summary:An anatomic and radiologic study of lumbar and lumbosacral pedicle anatomy. To define the radiologic anatomy of the lumbar and first sacral pedicle in the coaxial projection. Fluoroscopic assistance for pedicle screw placement requires radiologic landmarks. The radiologic landmarks have previously been assumed. Detailed study of the correlation between anatomy and radiology is required. Lumbar vertebrae and sacra were marked with radiopaque material to demonstrate the pedicle cortical borders. The vertebrae were then imaged in the coaxial projection to determine the correlation between the pedicle cortex and the radiologic image. Pedicle dimensions were recorded. Pedicle dimensions were consistent with known measurements, yet the long axis of the L4 and L5 pedicle ellipse was oblique to the vertical. Consequently, the minor diameter of the pedicle ellipse was considerably less than the measured pedicle width at L5. The radiologic pedicle image was consistently within the true pedicle cortex, by up to 3 mm, and probably represents the inner cortical border of the pedicle. The S1 pedicle has reliable anatomic landmarks, yet only the medial and superior borders were visualized. The radiologic pedicle image in the lumbar and lumbosacral spine is a reliable guide to the true bony cortex of the pedicle. At S1 the pedicle image is less well correlated with the cortical borders of the pedicle, yet other reliable anatomic landmarks exist.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-200003150-00010