ArticleGlobal spine journal2021
Pedicle Screws Challenged: Lumbar Cortical Density and Thickness Are Greater in the Posterior Elements Than in the Pedicles.
Article in Global spine journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- C-Arm Oblique View-Assisted Screw Placement Method for Extremely Small Lumbar Pedicles in Thoracolumbar Vertebral Body Fractures.International journal of spine surgery · 2026Article
- Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low-Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on TOrthopaedic surgery · 2025Article
- Impacts of Prior Anti-Osteoporosis Treatments on Sequential Denosumab Responses in BMD Changes Among Postmenopausal Osteoporosis Women in East China: Real-World Data Analysis.Clinical interventions in aging · 2025Article
- A novel pedicle screw design to maximize screw-bone interface strength using finite element analysis and design of experiment techniques.Asian spine journal · 2024Article
- Spinolaminar locking plates improve fixation strength compared to pedicle screws: a biomechanical analysis.Spine deformity · 2023Article
- Understanding a mass in the paraspinal region: an anatomical approach.Insights into imaging · 2023Review
- The association between paraspinal muscle parameters and vertebral pedicle microstructure in patients undergoing lumbar fusion surgery.International orthopaedics · 2023Article
- Three-Dimensional Hounsfield Units Measurement of Pedicle Screw Trajectory for Predicating Screw Loosening in Lumbar Fusion Surgery.Clinical interventions in aging · 2023Article
- Efficacy of Recombinant Human Parathyroid Hormone versus Vertebral Augmentation Procedure on Patients with Acute Osteoporotic Vertebral Compression Fracture.Orthopaedic surgery · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designControlled laboratory study.
objectiveTo measure the total bone mineral density (BMD), cortical volume, and cortical thickness in seven different anatomical regions of the lumbar spine.
methodsUsing computed tomography (CT) images, 3 cadaveric spines were digitally isolated by applying filters for cortical and cancellous bone. Each spine model was separated into 5 lumbar vertebrae, followed by segmentation of each vertebra into 7 anatomical regions of interest using 3-dimensional software modeling. The average Hounsfield units (HU) was determined for each region and converted to BMD with calibration phantoms of known BMD. These BMD measurements were further analyzed by the total volume, cortical volume, and cancellous volume. The cortical thickness was also measured. A similar analysis was performed by vertebral segment. St Mary's Medical Center's Institutional Review Board approved this study. No external funding was received for this work.
resultsThe lamina and inferior articular process contained the highest total BMD, thickest cortical shell, and largest percent volumes of cortical bone. The vertebral body demonstrated the lowest BMD. The BMDs of the L4 and L5 segments were lower; however, there were no statistically significant differences in BMD between the L1-L5 vertebral segments.
conclusionExtrapedicular regions of the lumbar vertebrae, including the lamina and inferior articular process, contain denser bone than the pedicles. Since screw pullout strength relies greatly on bone density, the lamina and inferior articular processes may offer stronger fixation of the lumbar spine.
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