ABSTRACT
Background: Pedicle screw fixation has become an increasingly popular technique of instrumentation to treat spinal disorders by providing stable fixation in the treatment for degenerative diseases, trauma, deformities, and tumours of the spine. This method provides rigid support that allows surgeons to limit instrumentation to one or two motion segments, thus preserving maximum motion. This study was conducted to record the surgically relevant parameters of transverse pedicle isthmus width, transverse pedicle angle, spinal canal diameters and the approximate screw path length and to compare the results between male and female vertebrae and with those of similar studies in literature. Methods: 295 lumbar vertebrae in 61patients were analyzed based on transverse pedicle isthmus width, transverse pedicle angles, AP and transverse spinal canal diameters and approximate screw path length. The screw path length was measured in 184 vertebrae from 37 patients. The measurements were processed using SPSS v.15 software and analysed. Results: The mean transverse pedicle isthmus width was the least at L1 level (8.1 mm) and highest at L5 level (16.5mm). There was a significant difference between male and female vertebral diameters. Of the pedicles at L1, over 9% had a diameter of less than or equal to 5 mm, 15% had a diameter of less than or equal to 6 mm. The mean transverse pedicle angle was maximum at L5 level (26.80). The canal diameters are significantly lower than that of the western population. There was a change in pedicle angle and diameter in the same vertebra between right and left pedicles. Female vertebrae had a smaller pedicle diameter and screw path length but had a similar spinal canal diameter as compared to a male vertebrae. Conclusions: Significant differences in the morphometric parameters existed between genders and even between individuals of same gender. It is suggested that preoperative computed tomography scans of the patients must be evaluated to choose the appropriately sized implant and avoid inadvertent complications.
ABSTRACT
Background: Osteoporosis is a major public health problem, associated with substantial morbidity and socio-economic burden. An early detection can help in reducing the fracture rates and overall socio-economic burden in such patients. The present study was carried out to screen the bone status (osteopenia and osteoporosis) above the age of 25 years in urban women population in this region. Methods: A hospital based study was carried out in 316 women by calculating T-scores utilizing calcaneal QUS as diagnostic tool. Results: The result suggested that a substantial female population had oesteopenia and osteoporosis after the age of 45 years. The incidence of osteoporosis was (20.25%) and osteopenia (36.79%) with maximum number of both osteoporosis and osteopenic women recorded in the age group of (55-64 years). After the age of 65 years, there was an almost 100% incidence of either osteopenia or osteoporosis, indicating that it increases with age and in postmenopausal period, thereby suggesting lack of estrogenic activity might be responsible for this increasing trend. Religion, caste and diet had an influence on the outcome of osteopenic and osteoporosis score in present study, but still it has to be substantiated by conducting larger randomized clinical trials in future. Conclusions: A substantial female population was screened for osteoporosis and osteopenia using calcaneal QUS method utilizing same WHO T score criteria that otherwise shall remain undiagnosed and face the complications and menace of osteoporosis.