Assessment of lumbar disc herniation-impaired gait by using IMU data fusion method.

The inertial motion unit (IMU) is an effective tool for monitoring and assessing gait impairment in patients with lumbar disc herniation(LDH). However, the current clinical assessment methods for LDH gait focus on patients' subjective scoring indicators and lack the assessment of kinematic ability; at the same time, individual differences in the motor function degradation of the healthy and affected lower limbs of LDH patients are also ignored. To solve this problem, we propose an LDH gait feature model based on multi-source adaptive Kalman data fusion of acceleration and angular velocity. The gait phase is segmented by using an adaptive Kalman data fusion algorithm to estimate the attitude angle, and obtaining gait events through a zero-velocity update technique and a peak detection algorithm. Two IMUs were used to analyze the gait characteristics of lumbar disc patients and healthy gait people, including 12 gait characteristics such as gait spatiotemporal parameters, kinematic parameters, gait variability and stability. Statistical methods were used to analyze the characteristic model and verify the biological differences between the healthy affected side of LDH and healthy subjects. Finally, feature engineering and machine learning technology were used to identify the gait pattern of inertial movement units in patients with lumbar intervertebral disc disease, and achieved a classification accuracy of 95.50%, providing an effective gait feature set and method for clinical evaluation of LDH.

Comparison of perioperative outcomes in obese and non-obese patients subjected to open lumbar spine surgery.

OBJECTIVE: Obesity is a global epidemic affecting developing countries. The relationship between obesity and perioperative outcomes during elective lumbar spine surgery remains controversial, especially in those without morbid disease. MATERIALS AND METHODS: We retrospectively revised the medical records of patients with lumbar spine degeneration subjected to elective surgery. The data retrieved included demographic and clinical characteristics, body mass index (BMI), obesity status (BMI ≥ 30), surgical interventions, estimated blood loss (EBL), operative time, length of stay (LOS), and post-operative complications. Perioperative outcomes were compared between Grade I-II obese and non-obese individuals. RESULTS: We enrolled 53 patients, 18 with Grade I-II obesity. Their median age was 51, with no differences in gender, comorbidities, laboratory parameters, and surgical procedures received between groups. No clinically relevant differences were found between grade I-II obese and non-obese participants in EBL (300 mL vs. 250 mL, p = 0.069), operative time (3.2 h vs. 3.0 h, p = 0.037), and LOS (6 days vs. 5 days, p = 0.3). Furthermore, BMI was not associated with the incidence of significant bleeding and long stay but showed a modest correlation with operative time. CONCLUSION: Grade I-II obesity does not increase surgical complexity nor perioperative complications during open lumbar spine surgery.

OBJETIVO: La obesidad es una epidemia mundial que afecta a países subdesarrollados. Su relación con los resultados de la cirugía de columna lumbar electiva sigue siendo controvertida, especialmente en obesos sin enfermedad mórbida. MÉTODOS: Se revisaron los expedientes de pacientes con degeneración de la columna lumbar sometidos a cirugía. Los datos recuperados incluyeron características demográficas y clínicas, índice de masa corporal (IMC), estado de obesidad (IMC > 30), intervenciones quirúrgicas, sangrado estimado, tiempo operatorio, tiempo de estancia y complicaciones. Los resultados se compararon entre individuos obesos grado I-II y controles. RESULTADOS: Se incluyeron 53 pacientes, 18 con obesidad de grado I-II. La edad media fue de 51 años, sin diferencias en el sexo, las comorbilidades, los parámetros de laboratorio y los procedimientos quirúrgicos recibidos entre grupos. No se encontraron diferencias relevantes entre los participantes obesos y los no obesos en sangrado (300 vs. 250 mL, p = 0.069), tiempo operatorio (3.2 vs. 3.0 horas, p = 0.037) y estancia (6 vs. 5 días, p = 0.3). El IMC no se asoció con hemorragia y larga estancia, pero mostró una correlación modesta con el tiempo operatorio. CONCLUSIONES: La obesidad grado I-II no predispone a complicaciones durante la cirugía de columna lumbar.

Recomendaciones para la recuperación posquirúrgica optimizada en columna (REPOC) / Recommendations for enhanced post-surgical recovery in the spine (REPOC)

Introducción y objetivos: La recuperación posquirúrgica optimizada en columna (REPOC) constituye un enfoque multimodal, basado en la evidencia científica disponible, que consigue una mejora eficaz de la funcionalidad fisiológica del paciente, reduce el dolor e incluso disminuye los costes hospitalarios. El objetivo de este trabajo es proponer unos estándares para la aplicación de la REPOC a la cirugía de fusión lumbar. Métodos: Se constituyó ad hoc un grupo multidisciplinario de expertos que revisaron la evidencia disponible y plantearon recomendaciones consensuadas para la artrodesis lumbar, utilizando el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Resultados: Se seleccionaron 23 recomendaciones en las fases preoperatoria, intraoperatoria y postoperatoria de la intervención quirúrgica. También se elaboró una lista de 29 ítems para la aplicación de la REPOC en cirugía de columna. Conclusiones: Este listado de recomendaciones facilitará la implementación del enfoque REPOC como herramienta segura y eficaz para la reducción de los eventos adversos en nuestro entorno.(AU)

Introduction/objectives: Enhanced recovery after surgery (ERAS) constitutes a multimodal approach, based on available scientific evidence, that achieves better patient's functionality, reduces pain, and even lowers financial costs. The present consensus statement proposes the standards for the implementation of ERAS programs to lumbar fusion surgery, a meant benchmark we call REPOC. Methodology: A multidisciplinary group of experts was set up ad hoc to review consensus recommendations for lumbar arthrodesis, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Results: As a result, 23 recommendations were selected throughout the preoperative, intraoperative, and postoperative phases of the surgical procedure. A 29-item checklist was also drawn up to implement REPOC protocols in spinal surgeries. Conclusions: This list of recommendations will facilitate the implementation of this multimodal approach as a safe and effective tool for reducing adverse events in our environment.(AU)

[Translated article] Recommendations for enhanced post-surgical recovery in the spine (REPOC) / Recomendaciones para la recuperación posquirúrgica optimizada en columna (REPOC)

Introducción y objetivos: La recuperación posquirúrgica optimizada en columna (REPOC) constituye un enfoque multimodal, basado en la evidencia científica disponible, que consigue una mejora eficaz de la funcionalidad fisiológica del paciente, reduce el dolor e incluso disminuye los costes hospitalarios. El objetivo de este trabajo es proponer unos estándares para la aplicación de la REPOC a la cirugía de fusión lumbar. Métodos: Se constituyó ad hoc un grupo multidisciplinario de expertos que revisaron la evidencia disponible y plantearon recomendaciones consensuadas para la artrodesis lumbar, utilizando el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Resultados: Se seleccionaron 23 recomendaciones en las fases preoperatoria, intraoperatoria y postoperatoria de la intervención quirúrgica. También se elaboró una lista de 29 ítems para la aplicación de la REPOC en cirugía de columna. Conclusiones: Este listado de recomendaciones facilitará la implementación del enfoque REPOC como herramienta segura y eficaz para la reducción de los eventos adversos en nuestro entorno.(AU)

Introduction/objectives: Enhanced recovery after surgery (ERAS) constitutes a multimodal approach, based on available scientific evidence, that achieves better patient's functionality, reduces pain, and even lowers financial costs. The present consensus statement proposes the standards for the implementation of ERAS programs to lumbar fusion surgery, a meant benchmark we call REPOC. Methodology: A multidisciplinary group of experts was set up ad hoc to review consensus recommendations for lumbar arthrodesis, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Results: As a result, 23 recommendations were selected throughout the preoperative, intraoperative, and postoperative phases of the surgical procedure. A 29-item checklist was also drawn up to implement REPOC protocols in spinal surgeries. Conclusions: This list of recommendations will facilitate the implementation of this multimodal approach as a safe and effective tool for reducing adverse events in our environment.(AU)

Recommendations for enhanced post-surgical recovery in the spine (REPOC). / Recomendaciones para la recuperación posquirúrgica optimizada en columna (REPOC).

INTRODUCTION/OBJECTIVES: Enhanced recovery after surgery (ERAS) constitutes a multimodal approach, based on available scientific evidence, that achieves better patient's functionality, reduces pain, and even lowers financial costs. The present consensus statement proposes the standards for the implementation of ERAS programs to lumbar fusion surgery, a meant benchmark we call REPOC. METHODOLOGY: A multidisciplinary group of experts was set up ad hoc to review consensus recommendations for lumbar arthrodesis, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS: As a result, 23 recommendations were selected throughout the preoperative, intraoperative, and postoperative phases of the surgical procedure. A 29-item checklist was also drawn up to implement REPOC protocols in spinal surgeries. CONCLUSIONS: This list of recommendations will facilitate the implementation of this multimodal approach as a safe and effective tool for reducing adverse events in our environment.

[Translated article] Recommendations for enhanced post-surgical recovery in the spine (REPOC).

INTRODUCTION/OBJECTIVES: Enhanced recovery after surgery (ERAS) constitutes a multimodal approach, based on available scientific evidence, that achieves better patient's functionality, reduces pain, and even lowers financial costs. The present consensus statement proposes the standards for the implementation of ERAS programmes to lumbar fusion surgery, a meant benchmark we call REPOC. METHODOLOGY: A multidisciplinary group of experts was set up ad hoc to review consensus recommendations for lumbar arthrodesis, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS: As a result, 23 recommendations were selected throughout the preoperative, intraoperative, and postoperative phases of the surgical procedure. A 29-item checklist was also drawn up to implement REPOC protocols in spinal surgeries. CONCLUSIONS: This list of recommendations will facilitate the implementation of this multimodal approach as a safe and effective tool for reducing adverse events in our environment.

Paraspinal muscle atrophy after posterior lumbar surgery with and without pedicle screw fixation with the classic technique. / Atrofia de la musculatura paraespinal después de cirugía lumbar posterior con y sin fijación transpedicular por la técnica clásica.

OBJECTIVES: Lumbar spine surgery causes a muscular injury during its approach that could worsen long-term postoperative functional results. This study aims to analyze the postoperative paraspinal atrophy associated with two types of intervention. MATERIAL AND METHODS: Clinical records and lumbar magnetic resonance imaging were collected from a group of 41 patients, 20 underwent laminectomy with lumbar fixation due to lumbar spinal stenosis (fixation group) and another group of 21 underwent hemilaminectomy without fixation due to lumbar disc disease (non-fixation group). In which muscle atrophy was analyzed quantitatively. RESULTS: We found a negative correlation between age and preoperative muscle, which was higher in those who underwent lumbar fixation (rho = -0.64 p = .002). We also found a positive correlation between preoperative muscle and postoperative atrophy (rho = 0.32 p = .041). In the age, sex and fixation adjusted multivariate linear regression model (R2 = 0.31), laminectomy with fixation is attributed to 5.3% atrophy (IC95 1.4-9.5%, p = .017); preoperative musculature > 70% is attributed to atrophy of 13.8% (95% CI 5.5%-22%, p = .002). Age did not correlate with postoperative atrophy. CONCLUSIONS: Paraspinal muscle atrophy after lumbar spinal surgery is greater if an extensive approach is performed such as complete laminectomy with bilateral facetectomy and transpedicular fixation. A greater previous musculature regardless of age, sex and type of surgery also predicts greater postoperative atrophy.

Retroperitoneal hematoma after using the extreme lateral interbody fusion (XLIF) approach: Presentation of a case and a review of the literature. / Hematoma retroperitoneal tras fusión lumbar intersomática mediante abordaje lateral transpsoas (XLIF): revisión de literatura a propósito de un caso.

The transpsoas approach, also known as extreme lateral interbody fusion (XLIF), to the lumbar spine is a novel minimally invasive technique with positive clinical outcomes and a low complication rate. There is a low risk of bleeding, due to this approach causing less soft tissue disruption than traditional spine surgery, but segmental arteries and great vessels can be damaged. Retroperitoneal haematoma is a major complication, with few cases reported. This is the first case reported in a Stand-alone XLIF and also the first case reported with haemorrhagic shock. Non-specific symptoms such tachycardia, hypotension, and anaemia are the most prevalent in this complication. With this case, our aim is to describe serious complications related to XLIF.

Correlation between obesity, sagittal balance and clinical outcome in spinal fusion / Correlação entre obesidade, equilíbrio sagital e resultado clínico em artrodese da coluna vertebral / Correlación entre obesidad, equilibrio sagital y resultado clínico en la artrodesis espinal

Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI) and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS) and the Oswestry questionnaire (ODI). Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83). There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively).Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.

Objetivo:Correlacionar a obesidade com os parâmetros radiográficos do equilíbrio sagital espinhal e espinopélvico em pacientes submetidos à artrodese da coluna vertebral, além de correlacionar a obesidade com o resultado clínico de tais pacientes.Métodos:Estudo observacional, retrospectivo, que incluiu pacientes submetidos a artrodese da coluna vertebral, com período de seguimento mínimo de três meses. Medimos a circunferência abdominal, assim como a altura e o peso, para o cálculo do índice de massa corporal (IMC) e obtivemos radiografias da coluna total. Os parâmetros clínicos estudados foram: dor pela escala visual analógica (EVA) e o questionário de Oswestry (ODI). Correlacionamos obesidade com os parâmetros radiográficos do equilíbrio sagital e espinopélvico e com os parâmetros clínicos pós-operatórios.Resultados:Foram analisados 32 pacientes. Quanto maior o IMC, maior foi o valor da EVA encontrado, porém sem significância estatística (p = 0,83). Também não houve correlação entre o IMC e o questionário ODI. Analisando a circunferência abdominal, não houve correlação com EVA ou ODI. Não houve correlação entre IMC ou circunferência abdominal e os parâmetros radiográficos do alinhamento sagital e espinopélvico. Quanto ao resultado pós-operatório, não houve correlação entre as médias do IMC e da circunferência abdominal e o resultado pós-operatório pelo ODI e pela EVA (p = 0,75 e p = 0,7, respectivamente).Conclusões:Os resultados clínicos de pacientes submetidos a artrodese da coluna vertebral não foram alterados pelo IMC e pela circunferência abdominal. Também não se observou correlação entre os parâmetros radiográficos do equilíbrio sagital espinhal e espinopélvico com a obesidade em pacientes previamente submetidos a cirurgia de artrodese da coluna vertebral.

Objetivo:Correlacionar la obesidad con los parámetros radiográficos del equilibrio sagital vertebral y espinopélvico en pacientes sometidos a artrodesis vertebral y correlacionar la obesidad con la resultado clínico de estos pacientes.Métodos:Estudio observacional y retrospectivo que incluyó pacientes sometidos a la artrodesis de la columna vertebral con un período de seguimiento mínimo de tres meses. Se midió la circunferencia de la cintura, así como la altura y el peso para calcular el índice de massa corporal (IMC) y se obtuvo radiografías de la columna total. Los parámetros clínicos estudiados fueron el dolor mediante la escala visual analógica (EVA) y el cuestionario de Oswestry (ODI). La obesidad fue correlacionada con los parámetros radiográficos del balance sagital y espinopélvico y parámetros clínicos postoperatorios.Resultados:Se analizaron 32 pacientes. Cuanto mayor sea el índice de masa corporal, mayor será el valor de EVA, pero sin significación estadística (p = 0,83). Tampoco hubo correlación entre el IMC y el cuestionario ODI. Analizando la circunferencia abdominal, no hubo correlación con EVA u ODI. No hubo correlación entre el IMC o la circunferencia de la cintura y los parámetros radiográficos de la alineación sagital y espinopélvica. En cuanto el resultado postoperatorio, no hubo correlación entre la media de IMC y la circunferencia de la cintura y los resultados postoperatorios por el ODI o EVA (p = 0,75 y p = 0,7, respectivamente).Conclusiones:Los resultados clínicos de pacientes sometidos a la artrodesis de la columna vertebral no se vieron afectados por el IMC y la circunferencia de la cintura. Además no había correlación entre los parámetros radiográficos del equilibrio sagital de la columna y el espinopélvico con la obesidad en pacientes previamente tratados con artrodesis de la columna vertebral.

Axial interbody arthrodesis of the L5-S1 segment: a systematic review of the literature.

OBJECT: The object of this study was to determine the fusion rate and safety profile of an axial interbody arthrodesis of the L5-S1 motion segment. METHODS: A systematic search of MEDLINE was conducted for literature published between January 1, 2000, and August 17, 2014. All peer-reviewed articles related to the fusion rate of L5-S1 and the safety profile of an axial interbody arthrodesis were evaluated. RESULTS: Seventy-four articles were identified, but only 15 (13 case series and 2 retrospective cohort studies) met the study inclusion criteria. The overall pseudarthrosis rate at L5-S1 was 6.9%, and the rate of all other complications was 12.9%. A total of 14.4% of patients required additional surgery, and the infection rate was 5.4%. Deformity studies reported a significantly increased rate of complications (46.3%), and prospectively collected data demonstrated significantly higher complication (36.8%) and revision (22.6%) rates. Lastly, studies with a conflict of interest reported lower complication rates (12.4%). CONCLUSIONS: A systematic review of the literature indicates that an axial interbody fusion performed at the lumbosacral junction is associated with a high fusion rate (93.15%) and an acceptable complication rate (12.90%). However, these results are based mainly on retrospective case series by authors with a conflict of interest. The limited prospective data available indicate that the actual fusion rate may be lower and the complication rate may be higher than currently reported.

Cajas intersomáticas lumbares: ¿medios de fusión o solo espaciadores? / Lumbar interbody cages: fusing means or only spacers?

Introducción: La fusión quirúrgica de la columna lumbar es un método muy utilizado para el tratamiento de la inestabilidad segmentaria lumbar dolorosa. En la actualidad, las dos técnicas de fusión instrumentada más utilizadas son la fusión posterolateral con tornillos pedicula-res y la fusión circunferencial mediante asociación de caja intersomática. Si bien hay evidencia de que la asociación de dispositivos intersomáticos aumenta la tasa de fusión, la mayoría de los estudios no discriminan si esta se produce solo de forma posterolateral o si se asocia una fusión anterior. El objetivo de este trabajo es determinar si existe fusión ósea real a nivel de las cajas intersomáticas o si estas actúan solo como espaciadores. Materiales y métodos: Se analizaron 28 pacientes con patología de la columna lumbar sometidos a artrodesis lumbar circunferencial en un solo nivel entre mayo de 2007 y enero de 2012, mediante tomografía computarizada posquirúrgica para valorar la presencia o no de artrodesis anterior. Se efectuó un estudio de valor terapéutico, descriptivo, de observación (nivel de evidencia IV); mediante evaluación estadística se realizó un análisis de frecuencias para describir la proporción de casos con fusión anterior. Resultados: Se detectó una tasa de fusión del 92,86% y falta de fusión radiológica anterior en el 7,14% de los pacientes. Conclusiones: Hay una alta tasa de fusión anterior a nivel de las cajas intersomáticas; de este modo, se demuestra que dichos dispositivos actúan como medios de fusión y no solo como espaciadores.(AU)

Background: Surgical fusion of the lumbar spine is a frequently used method for the treatment of painful lumbar segmental instability; currently the two instrumented fusion techniques most commonly used are posterolateral fusion with pedicle screws, and circumferential fusion by association of interbody cages. Although evidence shows that the association of intersomatic devices increases the fusion rate, most studies do not discriminate if this fusion occurs only posterolaterally, or an anterior fusion also occurs. The aim of this study is to determine if there is a true bone fusion at the level of interbody cages or if they act only as spacers. Methods: We analyzed 28 patients with lumbar spine pathology surgically treated with one level circumferential lumbar fusion from May 2007 to January 2012, using post-surgical computed tomography, to assess the presence or absence of anterior arthrodesis. A therapeutic value, descriptive, observational study was conducted (evidence level IV); by statistical evaluation, frequency analysis was performed to describe the proportion of cases with anterior fusion. Results: The fusion rate reached 92.86%; while there was no anterior radiological fusion in 7.14% of patients. Conclusions: There is a high rate of anterior fusion at the level of the interbody cages, thus demonstrating that these devices act as fusing means and not only as anterior spacers.(AU)

Cajas intersomáticas lumbares: ¿medios de fusión o solo espaciadores? / Lumbar interbody cages: fusing means or only spacers?

Introducción: La fusión quirúrgica de la columna lumbar es un método muy utilizado para el tratamiento de la inestabilidad segmentaria lumbar dolorosa. En la actualidad, las dos técnicas de fusión instrumentada más utilizadas son la fusión posterolateral con tornillos pedicula-res y la fusión circunferencial mediante asociación de caja intersomática. Si bien hay evidencia de que la asociación de dispositivos intersomáticos aumenta la tasa de fusión, la mayoría de los estudios no discriminan si esta se produce solo de forma posterolateral o si se asocia una fusión anterior. El objetivo de este trabajo es determinar si existe fusión ósea real a nivel de las cajas intersomáticas o si estas actúan solo como espaciadores. Materiales y métodos: Se analizaron 28 pacientes con patología de la columna lumbar sometidos a artrodesis lumbar circunferencial en un solo nivel entre mayo de 2007 y enero de 2012, mediante tomografía computarizada posquirúrgica para valorar la presencia o no de artrodesis anterior. Se efectuó un estudio de valor terapéutico, descriptivo, de observación (nivel de evidencia IV); mediante evaluación estadística se realizó un análisis de frecuencias para describir la proporción de casos con fusión anterior. Resultados: Se detectó una tasa de fusión del 92,86% y falta de fusión radiológica anterior en el 7,14% de los pacientes. Conclusiones: Hay una alta tasa de fusión anterior a nivel de las cajas intersomáticas; de este modo, se demuestra que dichos dispositivos actúan como medios de fusión y no solo como espaciadores.

Background: Surgical fusion of the lumbar spine is a frequently used method for the treatment of painful lumbar segmental instability; currently the two instrumented fusion techniques most commonly used are posterolateral fusion with pedicle screws, and circumferential fusion by association of interbody cages. Although evidence shows that the association of intersomatic devices increases the fusion rate, most studies do not discriminate if this fusion occurs only posterolaterally, or an anterior fusion also occurs. The aim of this study is to determine if there is a true bone fusion at the level of interbody cages or if they act only as spacers. Methods: We analyzed 28 patients with lumbar spine pathology surgically treated with one level circumferential lumbar fusion from May 2007 to January 2012, using post-surgical computed tomography, to assess the presence or absence of anterior arthrodesis. A therapeutic value, descriptive, observational study was conducted (evidence level IV); by statistical evaluation, frequency analysis was performed to describe the proportion of cases with anterior fusion. Results: The fusion rate reached 92.86%; while there was no anterior radiological fusion in 7.14% of patients. Conclusions: There is a high rate of anterior fusion at the level of the interbody cages, thus demonstrating that these devices act as fusing means and not only as anterior spacers.

Morphometry of pedicle and vertebral body in a Mexican population by CT and fluroscopy / Morfometría del cuerpo vertebral y pedículo en una población mexicana mediante TC y fluoroscopía

It is necessary to have precise anatomical knowledge of lumbar pedicles for the safe placement of screws. There are not reports about the morphometry of lumbar pedicles in a Mexican population exist. A descriptive, observational and cross-sectional study was done in 60 cadavers from the dissection lab of the Human Anatomy Department of the Medicine School. The aim of the study was to quantify the morphometric characteristics of the pedicles of the lumbar spine in a Mexican population. A total of 60 cadavers were evaluated by fluoroscopy and CT from L1 to L5, in the age range of 40 to 78 years. Each vertebral pedicle was measured in the axial, sagittal and coronal planes. The measurements included the minimum pedicle width, the pedicle angle, the distance to anterior cortex, and anteroposterior and interpedicular spinal canal diameters. CT evaluation showed a progressive and gradual increase in the width of the pedicles from L1 (7.81 +/- 1.30 mm) to L5 (14.36 +/- 14.36 mm). A progressive and gradual decrease of pedicle length from L1 (20.92 +/- 2.62 mm) to L5 (17.23 +/- 1.35 mm). When fluoroscopy was used there was the same relationship, but the values were higher than those obtained by CT. The values for widths and lengths are slightly higher in males than in females, but do not reveal any significant difference (p<0.05). The data in this study indicates that pedicle screws (5.5-6.5mm) may be used in the lumbar region.

Es necesario tener un conocimiento anatómico preciso de la morfología de los pedículos en la region lumbar para la colocación segura de tornillos intrapediculares. No existen reportes de la morfometría de los pedículos lumbares en la población Mexicana. Se desarrolló un estudio descriptivo, observacional y transversal en 60 cadaveres en el laboratorio del Departamento de Anatomía Humana de la Facultad de Medicina. El objetivo del estudio fue determinr las características morfométricas de los pedículos de la region lumbar en una muestra de población Mexicana. Se evaluaron las regiones lumbares (L1-L5) de un total de 60 cadaveres por fluroscopía y TC en un rango de edad entre 40 y 78 años. Cada pedículo fue medido en los planos axial, sagital y coronal. La evaluacion por TC muestra un aumento progresivo y gradual de la anchura de los pedículos de L1 (7,81 +/- 1,30 mm) a L5 (14,36 +/- 14,36 mm). También se observó una disminución gradul de la longitud del pedículo de L1 (14,36 +/- 14,36 mm) a L5 (17,23 +/- 1,35 mm). Al realizar las mediciones por fluroscopia se observaron las mismas condiciones, pero los valores fueron proporcionalmente mayores que los obtenidos por TC. La anchura y longitud pedicular fueron ligeramente mayores en hombres que en mujeres, pero no revelan significancia estadística (p<0,05). Los datos obtenidos del estudio indican que los tornillos intrapediculares (5,5- 6,5mm) pueden ser utilizados en la region lumbar.