Estimating Facet Joint Apposition with Specimen-Specific Computer Models of Subaxial Cervical Spine Kinematics

2021 ◽  
Author(s):  
Ryan D. Quarrington ◽  
Darcy W. Thompson-Bagshaw ◽  
Claire F. Jones
Keyword(s):  
Cervical Spine ◽  
Facet Joint ◽  
Computer Models ◽  
Subaxial Cervical Spine ◽  
Spine Kinematics

scholarly journals Subaxial lateral mass prosthesis for posterior reconstruction of cervical spine

2022 ◽  
Author(s):  
Qiang Jian ◽  
Zhenlei Liu ◽  
Wanru Duan ◽  
Fengzeng Jian ◽  
Zan Chen
Keyword(s):  
Cervical Spine ◽  
Joint Angle ◽  
Facet Joint ◽  
Posterior Fixation ◽  
Lateral Mass ◽  
Subaxial Cervical Spine ◽  
Fixation Plate ◽  
The Stability ◽  
Posterior Reconstruction ◽  
Surface Angle

Purpose: To obtain the relevant morphometry of the lateral mass of the subaxial cervical spine (C3-C7) and to design a series of lateral mass prostheses for the posterior reconstruction of the stability of cervical spine. Methods: The computed tomography (CT) scans of healthy volunteers were obtained. RadiAnt DICOM Viewer software (Version 2020.1, Medixant, Poland) was used to measure the parameters of lateral mass, such as height, anteroposterior dimension (APD), mediolateral dimension (MLD) and facet joint angle. According to the parameters, a series of cervical lateral mass prostheses were designed. Cadaver experiment was conducted to demonstrate its feasibility. Results: 23 volunteers with an average age of 30.1 ± 7.1 years were enrolled in this study. The height of lateral mass is 14.1 mm averagely. Facet joint angle, APD and MLD of lateral mass averaged 40.1 degrees, 11.2 mm and 12.18 mm, respectively. With these key data, a lateral mass prosthesis consists of a bone grafting column and a posterior fixation plate was designed. The column has a 4.0 mm radius, 41 degrees surface angle and adjustable height of 13, 15, or 17 mm. In the cadaver experiment, the grafting column could function as a supporting structure between adjacent facets, and it would not violate exiting nerve root (NR) or vertebral artery (VA). Conclusion: This study provided detailed morphology of the lateral mass of subaxial cervical spine. A series of subaxial cervical lateral mass prostheses were designed awaiting further clinical application.

scholarly journals Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

2018 ◽  
Vol 8 (2_suppl) ◽  
pp. 25S-33S ◽  
Author(s):  
Philipp Schleicher ◽  
Philipp Kobbe ◽  
Frank Kandziora ◽  
Matti Scholz ◽  
Andreas Badke ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Facet Joint ◽  
Posterior Instrumentation ◽  
Pedicle Screws ◽  
German Society ◽  
Vertebral Body Replacement ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries

Study Design: Expert consensus. Objectives: To establish treatment recommendations for subaxial cervical spine injuries based on current literature and the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma. Methods: This recommendation summarizes the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma. Results: Therapeutic goals are a stable, painless cervical spine and protection against secondary neurologic damage while retaining maximum possible motion and spinal profile. The AOSpine classification for subaxial cervical injuries is recommended. The Canadian C-Spine Rule is recommended to decide on the need for imaging. Computed tomography is the favoured modality. Conventional x-ray is preserved for cases lacking a “dangerous mechanism of injury.” Magnetic resonance imaging is recommended in case of unexplained neurologic deficit, prior to closed reduction and to exclude disco-ligamentous injuries. Computed tomography angiography is recommended in high-grade facet joint injuries or in the presence of vertebra-basilar symptoms. A0-, A1- and A2-injuries are treated conservatively, but have to be monitored for progressive kyphosis. A3 injuries are operated in the majority of cases. A4- and B- and C-type injuries are treated surgically. Most injuries can be treated with anterior plate stabilization and interbody support; A4 fractures need vertebral body replacement. In certain cases, additive or pure posterior instrumentation is needed. Usually, lateral mass screws suffice. A navigation system is advised for pedicle screws from C3 to C6. Conclusions: These recommendations provide a framework for the treatment of subaxial cervical spine Injuries. They give advice about diagnostic measures and the therapeutic strategy.

scholarly journals A Significant Correlation Between Osteoarthritis of the Atlantoaxial Facet Joint and a High-riding Vertebral Artery

2021 ◽  
Author(s):  
Tomoaki Shimizu ◽  
Masao Koda ◽  
Tetsuya Abe ◽  
Yosuke Shibao ◽  
Mamoru Kono ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cervical Spine ◽  
Vertebral Artery ◽  
Facet Joint ◽  
Pedicle Screws ◽  
Facet Joints ◽  
Cervical Spine Surgery ◽  
Subaxial Cervical Spine ◽  
Group A ◽  
Spine Disorders

Abstract Background A high-riding vertebral artery (HRVA) is an intraosseous anomaly that narrows the trajectory for C2 pedicle screws. The prevalence of a HRVA is high in patients who need surgery at the craniovertebral junction, but reports about HRVAs among subaxial cervical spine disorders are limited. We sought to determine the prevalence of HRVAs among patients with subaxial cervical spine disorders to elucidate the potential risk for VA injury in subaxial cervical spine surgery. Methods We included 215 patients, 94 were with a main lesion from C3 to C7 (subaxial group) and 121 were with a main lesion from T1 to L5 (thoracolumbar group). A HRVA was defined as a maximum C2 pedicle diameter of <3.5mm on axial CT. The sex, age of patients, body mass index (BMI), osteoarthritis of the atlantoaxial (C1/2) facet joints and prevalence of a HRVA in the 2 groups were compared and logistic regression was used to identify the factors correlate with a HRVA. Results The patients of subaxial group were younger than those of the thoracolumbar group but the sex and BMI didn’t differ significantly between the 2 groups. The osteoarthritis grade of C1/2 facet joints of the subaxial group was statistically higher than the thoracolumbar group. A HRVA was found in 26 patients of 94 (27.7 %) in the subaxial group and in 19 of 121 (15.7%) in the thoracolumbar group. The prevalence of a HRVA in the subaxial group was statistically higher and logistic regression analysis indicated that osteoarthritis of C1/2 facet joints significantly correlated with HRVA. Conclusions The prevalence of a HRVA in patients with subaxial cervical spine disorders is higher than in those without cervical spine disorders, and osteoarthritis of C1/2 facet joints significantly correlated with a HRVA.

scholarly journals Detecting Facet Joint and Lateral Mass Injuries of the Subaxial Cervical Spine in Major Trauma Patients

2015 ◽  
Vol 9 (3) ◽  
pp. 327 ◽  
Author(s):  
Joost Johannes van Middendorp ◽  
Ian Cheung ◽  
Kristian Dalzell ◽  
Hamish Deverall ◽  
Brian J.C. Freeman ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Major Trauma ◽  
Facet Joint ◽  
Trauma Patients ◽  
Lateral Mass ◽  
Subaxial Cervical Spine

Computed tomography–based determination of a safe trajectory for placement of transarticular facet screws in the subaxial cervical spine

2012 ◽  
Vol 16 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Gregory F. Jost ◽  
Erica F. Bisson ◽  
Meic H. Schmidt
Keyword(s):  
Cervical Spine ◽  
Facet Joint ◽  
Entry Point ◽  
Ct Scans ◽  
Screw Placement ◽  
Exit Point ◽  
Lateral Mass ◽  
Subaxial Cervical Spine ◽  
Clinical Series ◽  
The Mean

Object Placement of transarticular facet screws is one option for stabilization of the subaxial cervical spine. Small clinical series and biomechanical data support their role as a substitute for other posterior stabilization techniques; however, the application of transarticular facet screws in the subaxial cervical spine has not been widely adopted, possibly because of surgeon unfamiliarity with the trajectory. In this study, the authors' objective is to define insertion points and angles of safe trajectory for transarticular facet screw placement in the subaxial cervical spine. Methods Thirty fine-cut CT scans of cervical spines were reconstructed in the multiplanar mode and evaluated for safe transarticular screw placement in the subaxial cervical spine (C2–3, C3–4, C4–5, C5–6, C6–7). As in placement of lateral mass screws, the vertebral artery and exiting nerve root were bypassed posterolaterally. The entry point was set 1 mm medial and 1 mm caudal to the center of the lateral mass. From this entry point, the sagittal angulation was set to traverse the facet joint plane approximately perpendicularly. For the axial angulation, the exit point was set posterolaterally to the transverse process. After ideal insertion angles and screw lengths were identified, the trajectory was simulated on CT scans of 20 different cervical spines to confirm safe screw placement. Results The mean optimal mediolateral insertion angles (± SD) were as follows: 23° ± 5° at C2–3; 24° ± 4° at C3–4; 25° ± 5° at C4–5; 25° ± 4° at C5–6; and 33° ± 6° at C6–7. The mean sagittal insertion angles measured to the sagittal projection of the facet joint space were as follows: 77° ± 10° at C2–3; 77° ± 10° at C3–4; 80° ± 11° at C4–5; 81°± 8° at C5–6; and 100° ± 11° at C6–7. The mean trajectory lengths were 15 ± 2 mm at C2–3; 14 ± 1 mm at C3–4; 15 ± 1 mm at C4–5; 16 ± 2 mm at C5–6; and 23 ± 4 mm at C6–7. Simulation of these insertion angles on 20 different cervical spine CTs yielded a safe trajectory in 85%–95% of spines for C2–3, C3–4, C4–5, C5–6, and C6–7. Conclusions The calculated optimal insertion angles and lengths for each level may guide the safe placement of subaxial cervical transfacet screws.

scholarly journals Correlation between osteoarthritis of the atlantoaxial facet joint and a high‐riding vertebral artery

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tomoaki Shimizu ◽  
Masao Koda ◽  
Tetsuya Abe ◽  
Yosuke Shibao ◽  
Mamoru Kono ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Facet Joint ◽  
Pedicle Screws ◽  
Craniovertebral Junction ◽  
Facet Joints ◽  
Cervical Spine Surgery ◽  
Subaxial Cervical Spine ◽  
Group A ◽  
Spine Disorders

Abstract Background A high-riding vertebral artery (HRVA) is an intraosseous anomaly that narrows the trajectory for C2 pedicle screws. The prevalence of a HRVA is high in patients who need surgery at the craniovertebral junction, but reports about HRVAs in subaxial cervical spine disorders are limited. We sought to determine the prevalence of HRVAs among patients with subaxial cervical spine disorders to elucidate the potential risk for VA injury in subaxial cervical spine surgery. Methods We included 215 patients, 94 were with a main lesion from C3 to C7 (subaxial group) and 121 were with a main lesion from T1 to L5 (thoracolumbar group). A HRVA was defined as a maximum C2 pedicle diameter of < 3.5 mm on axial CT. The sex, age of patients, body mass index (BMI), osteoarthritis of the atlantoaxial (C1-2) facet joints, and prevalence of a HRVA in the 2 groups were compared and logistic regression was used to identify the factors correlated with a HRVA. Results The patients in the subaxial group were younger than those in the thoracolumbar group, but their sex and BMI did not differ significantly between the 2 groups. The mean osteoarthritis grade of the C1-2 facet joints of patients in the subaxial group was significantly higher than that in those in the thoracolumbar group. A HRVA was found in 26 patients of 94 (27.7 %) in the subaxial group and in 19 of 121 (15.7 %) in the thoracolumbar group. The prevalence of a HRVA in the subaxial group was significantly higher and osteoarthritis of C1-2 facet joints correlated significantly with a HRVA. Conclusions The prevalence of a HRVA in patients with subaxial cervical spine disorders is higher than in those without and osteoarthritis of the C1-2 facet joints is correlated with a HRVA.

scholarly journals Inter-examinerreliability study of physical examination procedures to assess the cervical spine

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Karthik V. Hariharan ◽  
Michael G. Timko ◽  
Christopher G. Bise ◽  
Meenakshi Sundaram ◽  
Michael J. Schneider
Keyword(s):  
Cervical Spine ◽  
Physical Examination ◽  
Facet Joint ◽  
Physical Therapists ◽  
Clinical Status ◽  
Clinical Findings ◽  
Qualitative Assessment ◽  
Segmental Mobility ◽  
Convenience Sample ◽  
Pain Provocation

Abstract Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.

Rheumatoid Pannus Presenting as a Large Epidural Mass in the Subaxial Cervical Spine: A Case Report

2021 ◽  
Author(s):  
Nathan K Leclair ◽  
Joshua Knopf ◽  
Michael Baldwin ◽  
Faripour Forouhar ◽  
Hilary Onyiuke
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Subaxial Cervical Spine
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