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As surgical skills develop in spinal field, transpedicular screw fixation of the lower thoracic, thoracolumbar, and lumbar spines have already been performed successfully, even using freehand technique by trained surgeons. The benefits of transpedicular screw fixation are widely accepted in the thoracolumbar spinal region for very stable fixation effect. Abumi et al first introduced transpedicular screw fixation in the subaxial cervical spinal region in 1991 and reported their initial clinical results in 1994 [1]. Since then, some other spinal surgeons began to accept transpedicular screw fixation in the subaxial cervical region as one choice [5]. But whether this fixation method can be accepted widely as a routine choice has been disputed till now. The main concern comes from the potential violation of the pedicle cortices and following damages to adjacent neurovascular structures [6][12]. To diminish subaxial cervical pedicle (SCP) screw malposition ratio as low as possible and to ensure successful clinical results, the complex morphologic features and projections of subaxial cervical pedicles should be clearly understood. That is, the exact diameter, inclinations at transverse and sagittal plane, cortical thicknesses at different orientations, and cortical thicknesses adjacent to pedicle entrance should be determined before any transpedicular screw fixation was performed, even by experienced surgeons using meticulous surgical techniques[Fig.1]. Although morphologic studies of the cervical spine have been reported as a way to evaluate the feasibility and safety of the technique, many have focused on transverse diameter of the pedicles, which is far from enough [3].Thorough understanding of the subaxial cervical spinal pedicle anatomy is mandatory to avoid injury to the vertebral artery, spinal cord or a nerve root [8][11][14]. Because of their inherent ability to render bony anatomy in three dimensions, CT scans can provide the best osseous detail of subaxial cervical pedicles. Volumetric CT could reconstruct multiplanar CT images based on raw sequential transaxial CT images [7]. Multiple planar reconstruction (MPR) CT images could provide vivid anatomic data of subaxial cervical pedicles at different planes and different orientations for further detailed study. MPR CT images can be reconstructed using the CT-machine attached Advantage Workstation. If time permitted, quantitative measurement of MPR CT images can be fulfilled using the measurement tools of the CT machine-attached Advantage Workstation. But in clinical practice, large clinical CT scanning tasks are under schedule,the Advantage

AutoCAD for Quantitative Measurement of Cervical MPR CT Images Reconstructed in ImageViewer Interface