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Research ArticleLumbar Spine

Demographic Analysis of Pedicle Diameter, and Estimated Pedicle Screw Length of the Lumbar Spine in a Diverse Population

Brandon Petrone, Joseph Albano, Robert Stockton, Aaron Atlas, Courtney Aronica and Kanwarpaul Grewal
International Journal of Spine Surgery April 2021, 8035; DOI: https://doi.org/10.14444/8035
Brandon Petrone
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
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Joseph Albano
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
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Robert Stockton
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
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Aaron Atlas
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
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Courtney Aronica
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
BA
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Kanwarpaul Grewal
Department of Orthopedic Surgery, Northwell Health Plainview Hospital, Plainview, New York
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ABSTRACT

Background Recent literature confirms the importance of understanding the variability in pedicle morphology among races. These studies suggest that more detailed and reliable measurements of pedicles should be undertaken. However, there is limited data on average pedicle diameters (PDs) or estimated pedicle screw lengths (EPSLs) between diverse racial populations. We sought to determine the differences in PD and EPSL in the lumbar spine between various races: “Asian,” “Black,” “White,” and “Hispanic” to aid in perioperative planning during instrumented spinal fusion.

Methods Axial cuts of 404 patients were inspected to obtain their transverse outer cortical PD as measured through the isthmus, and EPSL by measuring the posterior entry point at the longest distance, which perpendicularly transected the measured isthmic diameter, to the anterior vertebral cortex from L1 to L5. We examined the average PD and PD range at each level for each race. To determine the significance, we used a mixed analysis of variance and a post hoc analysis.

Results In this retrospective chart review the races were found to be significantly different in PD and EPSL (P < .001). Post hoc analysis using Dunn-Bonferroni correction showed that Asians had significantly smaller PDs than Blacks and Whites (P < .002 and P < .014, respectively). The White and Hispanic population had significantly longer EPSLs when compared to Blacks and Asians from L1 to L5 (P < .01).

Conclusions This study demonstrates that there are significant differences in pedicle morphology among races that must be taken into consideration when inserting pedicle screws during lumbar spinal fusion. Knowledge of these differences is of the utmost importance in order to limit complications while improving fixation.

Level of Evidence 3.

Clinical Relevance Pedicle morphology is variable between races and understanding these differences is important for the safe placement of pedicle screws.

  • pedicle screws
  • spine
  • osteology
  • demographics

Footnotes

  • Disclosures and COI: None declared.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Demographic Analysis of Pedicle Diameter, and Estimated Pedicle Screw Length of the Lumbar Spine in a Diverse Population
Brandon Petrone, Joseph Albano, Robert Stockton, Aaron Atlas, Courtney Aronica, Kanwarpaul Grewal
International Journal of Spine Surgery Apr 2021, 8035; DOI: 10.14444/8035

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Demographic Analysis of Pedicle Diameter, and Estimated Pedicle Screw Length of the Lumbar Spine in a Diverse Population
Brandon Petrone, Joseph Albano, Robert Stockton, Aaron Atlas, Courtney Aronica, Kanwarpaul Grewal
International Journal of Spine Surgery Apr 2021, 8035; DOI: 10.14444/8035
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