Yonsei Med J.  2015 Jan;56(1):159-166. 10.3349/ymj.2015.56.1.159.

Feasibility of Translaminar Screw Placement in Korean Population: Morphometric Analysis of Cervical Spine

• Ji GY
• Oh CH
• Park SH
• Kurniawan
• Lee J
• Jeon JK
• Shin DA
• Kim KN

• KMID: 2352802
• DOI: http://doi.org/10.3349/ymj.2015.56.1.159

Abstract

PURPOSE
To analyze the feasibility of unilateral and bilateral translaminar screw placement in Koran population, and compare the acceptance rate using previously reported data in American population.
MATERIALS AND METHODS
The translaminar lengths, thickness, heights, and sagittal-diagonal measurements were performed. The feasibility analysis was performed using unilateral and bilateral 3.5 mm cervical screw placement on the CT scans within 0.5 mm of safety margin. We also performed radiographic analysis of the morphometric dimensions and the feasibility of unilateral and bilateral translaminar screw placement at C3-C7.
RESULTS
Korean population had similar or significantly shorter translaminar lengths and thickness (lengths and thickness in C7 among males; lengths in C6-C7 and thickness in C4 among females) than American population, but had similar or significantly longer translaminar heights and sagittal-diagonal measurements (heights in C3-C7 and sagittal-diagonal measurements in C3-C6 among males; heights in C7 and sagittal-diagonal measurements in C3-C7 among females). Unilaterally, translaminar screw acceptance rates in C3-C7 were similar between Korean and American male population, but the rates in C4-C6 were significantly smaller between Korean and American female population. Bilaterally, translaminar screw acceptance rates in C3 and C5-C6 were significantly larger between Korean and American male population, but the rates in C3-C7 were similar between Korean and American female population.
CONCLUSION
The feasibility of unilateral and bilateral translaminar screw placement is different depending on different ethnics. Subaxial cervical unilateral translaminar screw placement among Korean male population and bilateral placement at C4-C7 among Korean female population are more acceptable than American population.

Keyword

Translaminar; cervical fusion; cervical spine; ethics; Korean; American

MeSH Terms

Adult
Aged
*Asian Continental Ancestry Group
*Bone Screws
Cervical Vertebrae/*radiography/*surgery
Demography
European Continental Ancestry Group
Feasibility Studies
Female
Humans
Male
Middle Aged
Republic of Korea
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Morphometric measurement on cervical computed tomography: A, translaminar length was measured from the junction of the lateral mass and lamina to the contralateral outer cortex of the spinous process; B, laminar thickness was measured as the greatest maximum thickness spanning from the ventromedial to the dorsolateral sides of the central portion of the lamina bilaterally; C, laminar height was recorded as the maximal height between the spinous process and the base of the pedicle in the coronal plane; and D, the sagittal-diagonal measurement was made from the most rostral point of the lamina to the most caudal portion of the lamina.

• 

  Fig. 2 Scatter plot between body height and translaminar length, thickness, height, and sagittal diagonal in cervical spine showed no linear relationship (all R2<0.100).

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  Fig. 3 Comparison of morphometric measurements between a Korean and American population. The results reported by Alvin, et al.1 are annotated as "Cleveland," while the results of the current study are indicated as "Korea". *p<0.050.

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