Authors: Peter Spangenberg Volker Coenen Joachim Michael Gilsbach Veit Rohde
Publish Date: 2005/11/01
Volume: 29, Issue: 2, Pages: 114-117
Abstract
We wanted to evaluate how often safe and effective posterior C1C2 transarticular screw placement is realizable when it is performed according to guidelines given in the literature In 50 adult patients computerized tomography scan data from C0 to C3 were transformed into a 3D spine model Virtually bilateral screws were placed from the medial third of the C2C3 facet joint towards the rim of the C1 anterior arc parallel to midline Three categories of virtual screw position were rated optimal virtual screw inside the C2 pars interarticularis transversing the middle third of the atlantoaxial joint and sparing the vertebral artery canal suboptimal virtual screw violating the C2 pars interarticularis and/or transversing the lower or upper third of the C1C2 joint and sparing vertebral artery canal and unacceptable virtual screw breaching the vertebral artery canal Optimal placement was seen in 74 suboptimal placement in 11 and unacceptable locations in 15 sites We conclude that due to the variability of the anatomy of the upper cervical spine optimal transarticular C1C2 screw placement is not possible in up to 26 and even hazardous in up to 15
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