Novel unilateral C1 double screw and ipsilateral C2 pedicle screw placement combined with contralateral laminar screw–rod fixation for atlantoaxial instability

2018 ◽  
Vol 28 (2) ◽  
pp. 362-369 ◽  
Author(s):  
Lei Shi ◽  
Kai Shen ◽  
Rui Deng ◽  
Zheng-Jian Yan ◽  
Kai-Lu Liang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Atlantoaxial Instability ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw ◽  
Laminar Screw

A New Entrance Technique for C2 Pedicle Screw Placement and the Use in Patients With Atlantoaxial Instability

2017 ◽  
Vol 30 (5) ◽  
pp. E573-E577 ◽  
Author(s):  
Jia-Ming Liu ◽  
Jian Jiang ◽  
Zhi-Li Liu ◽  
Xin-Hua Long ◽  
Wen-Zhao Chen ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Atlantoaxial Instability ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw

scholarly journals Anatomic considerations for C2 pedicle screw placement: the use of computerized tomography measurements

2009 ◽  
Vol 8 (1) ◽  
pp. 80-83
Author(s):  
Adebukoa Onibokun ◽  
Simona Bistazzoni ◽  
Marco Sassi ◽  
Larry T. Khoo
Keyword(s):  
Pedicle Screw ◽  
Computerized Tomography ◽  
Preoperative Planning ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw ◽  
Anatomical Knowledge ◽  
Axial Ct ◽  
The Mean ◽  
Pedicle Width

OBJECTIVE: more detailed anatomical knowledge of the C2 pedicle is required to optimize and minimize the risk of screw placement. The aim of this study was to evaluate the linear and angular dimensions of the true C2 pedicle using axial CT. METHODS: ninety three patients (47 males, 46 females mean age 48 years) who had cervical spinal CT imaging performed were evaluated for this study. Axial images of the C2 pedicle were selected and the following pedicle parameters were determined: pedicle width (PW, the mediolateral diameter of the pedicle isthmus, perpendicular to the pedicle axis) and pedicle transverse angle (PTA, that is, the angle between the pedicle axis and the midline of the vertebral body). RESULTS: the overall mean pedicle width was 5.8 1.2mm. The mean pedicle width in males (6.01.3mm) was greater than that in the female subjects (5.6 1.1mm). This difference was not found to be statistically significant (p=.6790). The overall mean pedicle transverse angle was 43.93.9 degrees. The mean PTA in males was 43.23.8 degrees, while that in females was 44.73.7 degrees. CONCLUSION: preoperative planning is absolutely mandatory, particularly in determining not only screw trajectory, but in analyzing individual patient anatomy and reception to a C2 pedicle screw.

scholarly journals Evaluation of C2 pedicle screw placement via the freehand technique by neurosurgical trainees

2018 ◽  
Vol 29 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Martin H. Pham ◽  
Joshua Bakhsheshian ◽  
Patrick C. Reid ◽  
Ian A. Buchanan ◽  
Vance L. Fredrickson ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Medical Center ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw ◽  
Canal Diameter ◽  
Screw Length ◽  
Freehand Technique ◽  
Screw Diameter

OBJECTIVEFreehand placement of C2 instrumentation is technically challenging and has a learning curve due the unique anatomy of the region. This study evaluated the accuracy of C2 pedicle screws placed via the freehand technique by neurosurgical resident trainees.METHODSThe authors retrospectively reviewed all patients treated at the LAC+USC Medical Center undergoing C2 pedicle screw placement in which the freehand technique was used over a 1-year period, from June 2016 to June 2017; all procedures were performed by neurosurgical residents. Measurements of C2 were obtained from preoperative CT scans, and breach rates were determined from coronal reconstructions on postoperative scans. Severity of breaches reflected the percentage of screw diameter beyond the cortical edge (I = < 25%; II = 26%–50%; III = 51%–75%; IV = 76%–100%).RESULTSNeurosurgical residents placed 40 C2 pedicle screws in 24 consecutively treated patients. All screws were placed by or under the guidance of Pham, who is a postgraduate year 7 (PGY-7) neurosurgical resident with attending staff privileges, with a PGY-2 to PGY-4 resident assistant. The authors found an average axial pedicle diameter of 5.8 mm, axial angle of 43.1°, sagittal angle of 23.0°, spinal canal diameter of 25.1 mm, and axial transverse foramen diameter of 5.9 mm. There were 17 screws placed by PGY-2 residents, 7 screws placed by PGY-4 residents, and 16 screws placed by the PGY-7 resident. The average screw length was 26.0 mm, with a screw diameter of 3.5 mm or 4.0 mm. There were 7 total breaches (17.5%), of which 4 were superior (10.0%) and 3 were lateral (7.5%). There were no medial breaches. The breaches were classified as grade I in 3 cases (42.9%), II in 3 cases (42.9%), III in 1 case (14.3%), and IV in no cases. There were 3 breaches that occurred via placement by a PGY-2 resident, 3 breaches by a PGY-4 resident, and 1 breach by the PGY-7 resident. There were no clinical sequelae due to these breaches.CONCLUSIONSFreehand placement of C2 pedicle screws can be done safely by neurosurgical residents in early training. When breaches occurred, they tended to be superior in location and related to screw length choice, and no breaches were found to be clinically significant. Controlled exposure to this unique anatomy is especially pertinent in the era of work-hour restrictions.

The Vertebral Artery Cave at C2: Anatomic Study with Application to C2 Pedicle Screw Placement

2016 ◽  
Vol 94 ◽  
pp. 368-374 ◽  
Author(s):  
R. Shane Tubbs ◽  
Andre Granger ◽  
Christian Fisahn ◽  
Marios Loukas ◽  
Marc Moisi ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Anatomic Study ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw

Computed Tomography-Guided C2 Pedicle Screw Placement for Treatment of Unstable Hangman Fractures

Spine ◽  
2014 ◽  
Vol 39 (18) ◽  
pp. E1058-E1065 ◽  
Author(s):  
Pankaj Kumar Singh ◽  
Kanwaljeet Garg ◽  
Duttaraj Sawarkar ◽  
Deepak Agarwal ◽  
Guru Dutta Satyarthee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw

Accuracy of C2 pedicle screw placement using the anatomic freehand technique

2014 ◽  
Vol 125 ◽  
pp. 24-27 ◽  
Author(s):  
Mohamad Bydon ◽  
Dimitrios Mathios ◽  
Mohamed Macki ◽  
Rafael De la Garza-Ramos ◽  
Nafi Aygun ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw ◽  
Freehand Technique
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