• Ruiwu Zheng, Yuchun Chen, Guanfeng Yao, Jicang Zeng, Xueming Ma, Guixin Yuan, and Xianghua Hu.
• Department of Orthopedics, The Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.
• World Neurosurg. 2024 Feb 1; 182: e721e733e721-e733.

BackgroundAnterior transpedicular screw (ATPS) internal fixation of the lower cervical spine is an alternative for patients who cannot tolerate combined anterior and posterior surgery. The cervical vertebral anatomy varies with many factors, including age, gender, height, weight, and race.MethodsThree-dimensional (3D) CT reconstructions were performed on 122 patients. We selected the best level and measured the relevant parameters on both sides of the cervical vertebrae.ResultsWe identified the entry point and orientation parameters of ATPS fixation for the C3-C7 vertebrae, and analyzed cervical pedicle parameters. Outer pedicle width (OPW), outer pedicle height (OPH), and pedicle axis length (PAL) were not correlated with body weight and age, but were positively correlated with body height (P < 0.05). After multiple linear regression analysis to exclude the effects of body height, no significant differences in OPW, OPH, and PAL were found between male and female subjects at most cervical levels. Pedicle cortical thickness was negatively correlated with age (P < 0.05). The percentage of pedicles with OPW <4.5 mm was: C3, 38.10%; C4, 34.92%; C5, 12.70%; C6, 9.52%; and C7, 0%. The percentage of pedicles with OPWs ≤4.5 mm, ≤4.0 mm, and ≤3.5 mm was higher among subjects with body height <160 cm.ConclusionsThis study presents the internal anatomy of the cervical spine and provides accurate preoperative evaluation data for ATPS fixation. OPW, OPH, and PAL are positively correlated with body height, while pedicle cortical thickness is negatively correlated with age.Copyright © 2023 Elsevier Inc. All rights reserved.

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