Ivan James Prithishkumar , Dineshwary Suresh , Nerissa Naidoo , Rashid AlSharhan , Usama Al Bastaki , Jeyaseelan Lakshmanan , Baylis Vivek Joseph
{"title":"Feasibility of transpedicular screw placement through the posterior arch of C1: A CT study in the Emirati population","authors":"Ivan James Prithishkumar , Dineshwary Suresh , Nerissa Naidoo , Rashid AlSharhan , Usama Al Bastaki , Jeyaseelan Lakshmanan , Baylis Vivek Joseph","doi":"10.1016/j.tria.2025.100384","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Instrumentation of the lateral mass of first cervical vertebra (C1) is required in atlantoaxial instability. C1 bears a complicated relationship with adjacent neurovascular structures such as the vertebral artery and cervical spinal cord, which are at risk of injury in a misplaced screw. The objective of this study was to look at the feasibility of transpedicular screw placement into the C1 lateral mass with entry through the posterior arch.</div></div><div><h3>Methods</h3><div>Computed tomography images of the cervical spine in 160 adults (>18 years) who are natives of the United Arab Emirates (UAE) (M = 80; F = 80) were reviewed. Morphometric parameters relevant to pedicle screw fixation via the posterior arch were studied.</div></div><div><h3>Results</h3><div>Mean intraosseous distance from screw entry point in the posterior arch to the anterior cortex of lateral mass following a straight course without any inclination was 28.0 mm in males and 29.0 mm in females, allowing a safe distance of 3.2 mm from the foramen transversarium laterally and 9.0 mm from the vertebral canal medially. A medial inclination of 18° in males and 14° in females allows for increased bone purchase. Mean height of the pedicle at its junction with lateral mass was 5.6 mm in both sexes. However, the mean height of the posterior arch at the vertebral artery groove was 3.3 ± 0.4 mm in males and 3.1 ± 0.4 mm in females.</div></div><div><h3>Conclusion</h3><div>We recommend placement of 3.5/4.0 mm screws using the notching technique, of length 28–30 mm with a slight medial angulation of 15° for increased bone purchase and greater stability of fixation.</div></div>","PeriodicalId":37913,"journal":{"name":"Translational Research in Anatomy","volume":"39 ","pages":"Article 100384"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational Research in Anatomy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214854X25000032","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Instrumentation of the lateral mass of first cervical vertebra (C1) is required in atlantoaxial instability. C1 bears a complicated relationship with adjacent neurovascular structures such as the vertebral artery and cervical spinal cord, which are at risk of injury in a misplaced screw. The objective of this study was to look at the feasibility of transpedicular screw placement into the C1 lateral mass with entry through the posterior arch.
Methods
Computed tomography images of the cervical spine in 160 adults (>18 years) who are natives of the United Arab Emirates (UAE) (M = 80; F = 80) were reviewed. Morphometric parameters relevant to pedicle screw fixation via the posterior arch were studied.
Results
Mean intraosseous distance from screw entry point in the posterior arch to the anterior cortex of lateral mass following a straight course without any inclination was 28.0 mm in males and 29.0 mm in females, allowing a safe distance of 3.2 mm from the foramen transversarium laterally and 9.0 mm from the vertebral canal medially. A medial inclination of 18° in males and 14° in females allows for increased bone purchase. Mean height of the pedicle at its junction with lateral mass was 5.6 mm in both sexes. However, the mean height of the posterior arch at the vertebral artery groove was 3.3 ± 0.4 mm in males and 3.1 ± 0.4 mm in females.
Conclusion
We recommend placement of 3.5/4.0 mm screws using the notching technique, of length 28–30 mm with a slight medial angulation of 15° for increased bone purchase and greater stability of fixation.
期刊介绍：
Translational Research in Anatomy is an international peer-reviewed and open access journal that publishes high-quality original papers. Focusing on translational research, the journal aims to disseminate the knowledge that is gained in the basic science of anatomy and to apply it to the diagnosis and treatment of human pathology in order to improve individual patient well-being. Topics published in Translational Research in Anatomy include anatomy in all of its aspects, especially those that have application to other scientific disciplines including the health sciences: • gross anatomy • neuroanatomy • histology • immunohistochemistry • comparative anatomy • embryology • molecular biology • microscopic anatomy • forensics • imaging/radiology • medical education Priority will be given to studies that clearly articulate their relevance to the broader aspects of anatomy and how they can impact patient care.Strengthening the ties between morphological research and medicine will foster collaboration between anatomists and physicians. Therefore, Translational Research in Anatomy will serve as a platform for communication and understanding between the disciplines of anatomy and medicine and will aid in the dissemination of anatomical research. The journal accepts the following article types: 1. Review articles 2. Original research papers 3. New state-of-the-art methods of research in the field of anatomy including imaging, dissection methods, medical devices and quantitation 4. Education papers (teaching technologies/methods in medical education in anatomy) 5. Commentaries 6. Letters to the Editor 7. Selected conference papers 8. Case Reports
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
