• Mengistu G Mengesha, Jalaj Meena, Karthik Ramachandran, Ajoy Prasad Shetty, Pushpa Bhari Thippeswamy, Rishi Mugesh Kanna, and Rajasekaran Shanmuganathan.
• Department of Spine Surgery, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, India.
• World Neurosurg. 2023 Dec 1; 180: e599e606e599-e606.

ObjectiveThis study aimed to determine the accuracy and reliability of using magnetic resonance imaging (MRI) to characterize thoracic pedicle morphology in the normal population.MethodsComputed tomography (CT) and MRI datasets of 63 surgically treated patients were included in the study. Bilateral T3, T6, T9, and T12 vertebral levels were evaluated for the type of pedicle, pedicle chord length, and pedicle isthmic diameter on both MRI and CT scans. Pedicles were classified according to Sarwahi et al. into type A (normal pedicle), >4 mm cancellous channel; type B, 2-4 mm channel; type C, completely cortical channels >2 mm; and type D, <2 mm cortical bone channel.ResultsOf 504 pedicles, 294 were classified as type A, 173 as type B, 24 as type C, and 13 as type D based on a CT scan. MRI had an overall accuracy rate of 92.86% for detecting type A, 96.53% for type B, and 100% for type C and type D compared with CT scans. Regarding the thoracic levels, MRI had an overall concordance of 97.98% at T3 level, 94.43% at T6 level, 98.11% at T9 level, and 99.3% at T12 level with CT readings. Comparing measurements between MRI and CT studies for pedicle isthmic diameter and pedicle chord length showed moderate to good reliability at all measured levels.ConclusionsPedicle measurements obtained by MRI may be used to estimate pedicle dimensions, allowing surgeons to preoperatively determine pedicle screw sizes based on MRI scans alone.Copyright © 2023 Elsevier Inc. All rights reserved.

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