Morphometric findings of the subaxial cervical spine among different geographic regions and the implications for cervical pedicle screw placement: a systematic review and meta-analysis

Although cervical pedicle screws (CPS) improve outcomes in trauma and deformity surgery, existing morphometric studies have not been systematically consolidated. This systematic review aims to pool available data to characterize subaxial cervical pedicle dimensions and insertion angles across geographically diverse populations and evaluate population-level anatomical variation relevant to cervical pedicle screw planning.

PubMed, Embase, and Google Scholar were searched to identify anatomical studies published between database inception and August 1, 2024 that reported computed tomography (CT) measurements obtained from at least 10 patients who underwent CPS placement or from at least 10 cadaveric specimens. Five measurements in these studies were analyzed: pedicle width (PW), pedicle height, mean screw length, pedicle transverse angle (PTA), and the difference between the widest and narrowest PTA along the subaxial cervical spine. Pooled means were analyzed for all subaxial vertebrae from patients in the different geographic regions identified during our literature search.