• World Neurosurg · May 2019

    A study of the sagittal angle of lumbar bicortical pedicle screws from the anatomical perspective of the lumbar artery.

    • Liehua Liu, Haoming Wang, Qian Wang, Jiangang Wang, Yong Liang, Ying Li, Qiang Liang, Weidong Jin, Qiang Zhou, and Zili Wang.
    • Department of Spinal Surgery, General Hospital of Ningxia Medical University, Yinchuan, China; Department of Spine Surgery, The Third Affiliated Hospital of Chongqing Medical University (General Hospital), Chongqing, China.
    • World Neurosurg. 2019 May 1; 125: e435-e441.

    ObjectiveTo observe anatomic relationships between lumbar bicortical pedicle screws (BPSs) at 2 sagittal section angles (SSAs) and lumbar artery (LA).MethodsWe observed 2 SSAs, vertical angle and cephalic angle, of the BPS. The positions at which the BPS breaks through the anterior vertebral cortex were defined as point A and point B. Distances from point A and point B to LAs were measured. The percentage of risk of injury to LAs was calculated according to these distances.ResultsAt the same transverse section angle on the left and right side in L1 and L2, distance from point A to LA was significantly greater than distance from point B to LA (P < 0.001) except at a transverse section angle of 0° on the right side in L2 (P > 0.05). At the same transverse section angle on the left in L3 and L4, distance from point B to LA was significantly greater than distance from point A to LA (P < 0.001). The percentages of high risk of injury to the LA resulting from BPSs at the vertical angle in L1 and L2 were 0%-6.2%. The percentages of high risk of injury to the LA resulting from BPSs at the cephalic angle on the left side in L3 and L4 were 0%-18.5%.ConclusionsLumbar BPSs present a risk of injury to the LA. The vertical angle is the recommended SSA for BPSs in L1 and L2, and the cephalic angle is the recommended SSA in L3 and L4.Copyright © 2019 Elsevier Inc. All rights reserved.

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