DOI: 10.11648/j.ijn.20261002.13 ISSN: 2640-1959

CT Morphometry of the Thoracic Spine in Congolese Melanoderm Subjects: Reference Norms for Spinal Surgery

Leon Boukassa, Regis Moyikoua, Paule Afejee, Rel Kala, Sinclair Bambino, Olivier Ngackosso, Hugues Mbaki
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Spinal morphometry exhibits significant interpopulation variability, which is well documented for the cervical and lumbar segments but remains poorly understood for the thoracic spine. This lack of specific data limits the clinical relevance of foreign reference standards in sub-Saharan populations. The objective of this study was to show normal computed tomography (CT) parameters for the thoracic vertebrae in healthy Congolese subjects and to analyze their variations according to sex and body mass index (BMI). A prospective cross-sectional study conducted at the Brazzaville University Hospital (April–September 2024) involving 81 dark-skinned volunteers (43 men, 38 women), aged 18 to 30 years, free of any spinal pathology. The sagittal (SD) and transverse (TD) diameters, vertebral body height (VH), right and left pedicular diameters (PD), and disc heights (DH) were measured on computed tomography (CT) slices with multiplanar reconstructions. The SD increased from T1 (1.63 cm) to T9 (2.54 cm) and then decreased through T12; the TD decreased from T1 to T4 and then increased through T12 (3.45 cm); and vertebral height increased steadily from T1 (1.57 cm) to T12 (2.27cm). The volume of the vertebral bodies, estimated using the elliptical cylinder model, increased from 5.35 cm3 (T1) to 15.23 cm3 (T12), representing a ratio of 2.85. The PDs were minimal at T4–T6 (0.51 cm) and maximal at T12 (0.78 cm), with no significant right-left asymmetry. Sexual dimorphism was observed from T3 to T8 (p < 0.02) on the HV and on the right DP at T1 (p = 0.03). DH values were higher in men at T2–T3, T3–T4, T6–T7, T7–T8 and T11–T12 (p < 0.05). BMI did not influence bone dimensions, except for an isolated difference at T5–T6 (p = 0.019). This study provides the first thoracic morphometric norms for Congolese individuals with dark skin. The cranio-caudal growth of vertebral volumes reflects biomechanical adaptation to an upright posture. Sexual dimorphism, limited to vertebral height in the mid-thoracic region, and the absence of pedicle dimorphism provide a precise framework for surgical planning. These data improve surgical safety in settings where neuronavigation is unavailable and support the development of local population-based standards.

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