The rib head as a landmark in the anterolateral approach to the thoracic spine

A computed tomography-based morphometric study

Kyriakos Papadimitriou, Anubhav G. Amin, Ryan M. Kretzer, Christopher Chaput, P. Justin Tortolani, Jean Paul Wolinsky, Ziya L. Gokaslan, Mhd-Ali - Baaj

Research output: Contribution to journalArticle

Abstract

Object: The rib head is an important landmark in the anterolateral approach to the thoracic spine. Resection of the rib head is typically the first step in gaining access to the underlying pedicle and ultimately the spinal canal. The goal of this work is to quantify the relationship of the rib head to the spinal canal and adjacent aorta at each thoracic level using CT-based morphometric measurements. Methods: One hundred thoracic spine CT scans (obtained in 50 male and 50 female subjects) were evaluated in this study. The width and depth of each vertebra body were measured from T-1 to T-12. In addition, the distance of each rib head to the spinal canal was determined by drawing a line connecting the rib heads bilaterally and measuring the distance to this line from the most ventral aspect of the spinal canal. Finally, the distance of the left rib head to the thoracic aorta was measured at each thoracic level below the aortic arch. Results: The vertebral body depth progressively increased in a rostral to caudal direction. The vertebral body width was at its minimum at T-4 and progressively increased to T-12. The rib head extended beyond the spinal canal maximally at T-1. This distance incrementally decreased toward the caudal levels, with the tip of the rib head lying approximately even with the ventral canal at T-11 and T-12. The distance between the aorta and the left rib head increased in a rostral to caudal direction as well. Conclusions: The rib head is an important landmark in the anterolateral approach to the thoracic spine. At more cephalad levels, a larger portion of rib head requires resection to gain access to the spinal canal. At more caudad levels, there is a safer working distance between the rib head and aorta.

Original languageEnglish (US)
Pages (from-to)484-489
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume18
Issue number5
DOIs
StatePublished - May 2013
Externally publishedYes

Fingerprint

Ribs
Spine
Thorax
Tomography
Spinal Canal
Aorta
Thoracic Aorta

Keywords

  • Anatomy
  • Computed tomography
  • Spinal fusion
  • Thoracic spine
  • Thoracic vertebrectomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

The rib head as a landmark in the anterolateral approach to the thoracic spine : A computed tomography-based morphometric study. / Papadimitriou, Kyriakos; Amin, Anubhav G.; Kretzer, Ryan M.; Chaput, Christopher; Tortolani, P. Justin; Wolinsky, Jean Paul; Gokaslan, Ziya L.; Baaj, Mhd-Ali -.

In: Journal of Neurosurgery: Spine, Vol. 18, No. 5, 05.2013, p. 484-489.

Research output: Contribution to journalArticle

Papadimitriou, Kyriakos ; Amin, Anubhav G. ; Kretzer, Ryan M. ; Chaput, Christopher ; Tortolani, P. Justin ; Wolinsky, Jean Paul ; Gokaslan, Ziya L. ; Baaj, Mhd-Ali -. / The rib head as a landmark in the anterolateral approach to the thoracic spine : A computed tomography-based morphometric study. In: Journal of Neurosurgery: Spine. 2013 ; Vol. 18, No. 5. pp. 484-489.
@article{c9219cdffe4b408c9e2cd076956e4cca,
title = "The rib head as a landmark in the anterolateral approach to the thoracic spine: A computed tomography-based morphometric study",
abstract = "Object: The rib head is an important landmark in the anterolateral approach to the thoracic spine. Resection of the rib head is typically the first step in gaining access to the underlying pedicle and ultimately the spinal canal. The goal of this work is to quantify the relationship of the rib head to the spinal canal and adjacent aorta at each thoracic level using CT-based morphometric measurements. Methods: One hundred thoracic spine CT scans (obtained in 50 male and 50 female subjects) were evaluated in this study. The width and depth of each vertebra body were measured from T-1 to T-12. In addition, the distance of each rib head to the spinal canal was determined by drawing a line connecting the rib heads bilaterally and measuring the distance to this line from the most ventral aspect of the spinal canal. Finally, the distance of the left rib head to the thoracic aorta was measured at each thoracic level below the aortic arch. Results: The vertebral body depth progressively increased in a rostral to caudal direction. The vertebral body width was at its minimum at T-4 and progressively increased to T-12. The rib head extended beyond the spinal canal maximally at T-1. This distance incrementally decreased toward the caudal levels, with the tip of the rib head lying approximately even with the ventral canal at T-11 and T-12. The distance between the aorta and the left rib head increased in a rostral to caudal direction as well. Conclusions: The rib head is an important landmark in the anterolateral approach to the thoracic spine. At more cephalad levels, a larger portion of rib head requires resection to gain access to the spinal canal. At more caudad levels, there is a safer working distance between the rib head and aorta.",
keywords = "Anatomy, Computed tomography, Spinal fusion, Thoracic spine, Thoracic vertebrectomy",
author = "Kyriakos Papadimitriou and Amin, {Anubhav G.} and Kretzer, {Ryan M.} and Christopher Chaput and Tortolani, {P. Justin} and Wolinsky, {Jean Paul} and Gokaslan, {Ziya L.} and Baaj, {Mhd-Ali -}",
year = "2013",
month = "5",
doi = "10.3171/2013.1.SPINE12605",
language = "English (US)",
volume = "18",
pages = "484--489",
journal = "Journal of Neurosurgery: Spine",
issn = "1547-5654",
publisher = "American Association of Neurological Surgeons",
number = "5",

}

TY - JOUR

T1 - The rib head as a landmark in the anterolateral approach to the thoracic spine

T2 - A computed tomography-based morphometric study

AU - Papadimitriou, Kyriakos

AU - Amin, Anubhav G.

AU - Kretzer, Ryan M.

AU - Chaput, Christopher

AU - Tortolani, P. Justin

AU - Wolinsky, Jean Paul

AU - Gokaslan, Ziya L.

AU - Baaj, Mhd-Ali -

PY - 2013/5

Y1 - 2013/5

N2 - Object: The rib head is an important landmark in the anterolateral approach to the thoracic spine. Resection of the rib head is typically the first step in gaining access to the underlying pedicle and ultimately the spinal canal. The goal of this work is to quantify the relationship of the rib head to the spinal canal and adjacent aorta at each thoracic level using CT-based morphometric measurements. Methods: One hundred thoracic spine CT scans (obtained in 50 male and 50 female subjects) were evaluated in this study. The width and depth of each vertebra body were measured from T-1 to T-12. In addition, the distance of each rib head to the spinal canal was determined by drawing a line connecting the rib heads bilaterally and measuring the distance to this line from the most ventral aspect of the spinal canal. Finally, the distance of the left rib head to the thoracic aorta was measured at each thoracic level below the aortic arch. Results: The vertebral body depth progressively increased in a rostral to caudal direction. The vertebral body width was at its minimum at T-4 and progressively increased to T-12. The rib head extended beyond the spinal canal maximally at T-1. This distance incrementally decreased toward the caudal levels, with the tip of the rib head lying approximately even with the ventral canal at T-11 and T-12. The distance between the aorta and the left rib head increased in a rostral to caudal direction as well. Conclusions: The rib head is an important landmark in the anterolateral approach to the thoracic spine. At more cephalad levels, a larger portion of rib head requires resection to gain access to the spinal canal. At more caudad levels, there is a safer working distance between the rib head and aorta.

AB - Object: The rib head is an important landmark in the anterolateral approach to the thoracic spine. Resection of the rib head is typically the first step in gaining access to the underlying pedicle and ultimately the spinal canal. The goal of this work is to quantify the relationship of the rib head to the spinal canal and adjacent aorta at each thoracic level using CT-based morphometric measurements. Methods: One hundred thoracic spine CT scans (obtained in 50 male and 50 female subjects) were evaluated in this study. The width and depth of each vertebra body were measured from T-1 to T-12. In addition, the distance of each rib head to the spinal canal was determined by drawing a line connecting the rib heads bilaterally and measuring the distance to this line from the most ventral aspect of the spinal canal. Finally, the distance of the left rib head to the thoracic aorta was measured at each thoracic level below the aortic arch. Results: The vertebral body depth progressively increased in a rostral to caudal direction. The vertebral body width was at its minimum at T-4 and progressively increased to T-12. The rib head extended beyond the spinal canal maximally at T-1. This distance incrementally decreased toward the caudal levels, with the tip of the rib head lying approximately even with the ventral canal at T-11 and T-12. The distance between the aorta and the left rib head increased in a rostral to caudal direction as well. Conclusions: The rib head is an important landmark in the anterolateral approach to the thoracic spine. At more cephalad levels, a larger portion of rib head requires resection to gain access to the spinal canal. At more caudad levels, there is a safer working distance between the rib head and aorta.

KW - Anatomy

KW - Computed tomography

KW - Spinal fusion

KW - Thoracic spine

KW - Thoracic vertebrectomy

UR - http://www.scopus.com/inward/record.url?scp=84877761219&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877761219&partnerID=8YFLogxK

U2 - 10.3171/2013.1.SPINE12605

DO - 10.3171/2013.1.SPINE12605

M3 - Article

VL - 18

SP - 484

EP - 489

JO - Journal of Neurosurgery: Spine

JF - Journal of Neurosurgery: Spine

SN - 1547-5654

IS - 5

ER -