Abstract:

Objective: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity, and pedicle morphology can change on the concave and convex sides of the curvature. This study aimed to evaluate the pedicle morphology of the thoracic and lumbar vertebrae in AIS via computed tomography (CT). Materials and Methods: Patients diagnosed with AIS between 2019 and 2021 were identified by scanning the Picture Archiving and Communication System. Patients with a scoliosis radiograph and a Cobb angle of 40º or more were included in the study. The pedicle length (PL), axial pedicle angle (APA), endosteal pedicle width (EPW), and cord length (CL) were measured from the T1 to L5 vertebrae from the CT sections of the patients. The Cobb angle, apical vertebral translation distance, and vertebral rotations were measured using standing AP and lateral radiographs. Results: The mean age of the 30 patients was 16.37±3.0 and 93.3% were females. The mean main-thoracic Cobb angle was 47.87º±7.99º. There was a significant, negatively weak relationship between the Cobb angle and T5 and T6 left PL (r=-0.485 and r=-0.371, respectively), a moderately negative relationship between T7 and L3 left PL (r=0.506 and r=-0.508, respectively). There was no significant correlation between the Cobb angle and endosteal pedicle values (p>0.05). While the correlation between the vertebral rotation and the right endosteal pedicle was moderate at T4, a significant but low correlation was found for T3, T5, T6, T7, and T9 (p<0.05). Conclusion: The EPW was shorter and the CL was longer on the concave side of the vertebrae in the apical region of the AIS deformity. It is essential to know the pedicle morphology order to avoid complications, especially in pedicle screw implantation in the apical concave region.

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