The Ponticulus Posticus as Risk Factor for Screw Insertion into the First Cervical Lateral Mass

2018 ◽  
Vol 113 ◽  
pp. e579-e585 ◽  
Author(s):  
Dilek Arslan ◽  
Mehmet Asim Ozer ◽  
Figen Govsa ◽  
Omer Kıtıs
Keyword(s):  
Risk Factor ◽  
Lateral Mass ◽  
Screw Insertion ◽  
Ponticulus Posticus

Transfacet screw placement for posterior fixation of C-7

2008 ◽  
Vol 9 (2) ◽  
pp. 200-206 ◽  
Author(s):  
Eric M. Horn ◽  
Nicholas Theodore ◽  
Neil R. Crawford ◽  
Nicholas C. Bambakidis ◽  
Volker K. H. Sonntag
Keyword(s):  
Intraoperative Complications ◽  
Pedicle Screws ◽  
Retrospective Chart Review ◽  
Screw Placement ◽  
Posterior Fixation ◽  
Lateral Mass ◽  
Screw Insertion ◽  
Novel Technique ◽  
Hardware Failures

Object Lateral mass screws are traditionally used to fixate the subaxial cervical spine, while pedicle screws are used in the thoracic spine. Lateral mass fixation at C-7 is challenging due to thin facets, and placing pedicle screws is difficult due to the narrow pedicles. The authors describe their clinical experience with a novel technique for transfacet screw placement for fixation at C-7. Methods A retrospective chart review was undertaken in all patients who underwent transfacet screw placement at C-7. The technique of screw insertion was the same for each patient. Polyaxial screws between 8- and 10-mm-long were used in each case and placed through the facet from a perpendicular orientation. Postoperative radiography and clinical follow-up were analyzed for aberrant screw placement or construct failure. Results Ten patients underwent C-7 transfacet screw placement between June 2006 and March 2007. In all but 1 patient screws were placed bilaterally, and the construct lengths ranged from C-3 to T-5. One patient with a unilateral screw had a prior facet fracture that precluded bilateral screw placement. There were no intraoperative complications or screw failures in these patients. After an average of 6 months of follow-up there were no hardware failures, and all patients showed excellent alignment. Conclusions The authors present the first clinical demonstration of a novel technique of posterior transfacet screw placement at C-7. These results provide evidence that this technique is safe to perform and adds stability to cervicothoracic fixation.

scholarly journals The Prevalence of Skeletotopy Variation of the Atlas and Vertebral Arteries Among Lithuanians and Its Significance for Physical Medicine Procedures and Rehabilitation

2019 ◽  
Vol 1 (12) ◽  
Author(s):  
Rimvydas Stropus ◽  
Ernesta Naujokaitė ◽  
Ieva Sakalauskaitė
Keyword(s):  
Risk Factor ◽  
Vertebral Artery ◽  
Anatomical Variations ◽  
The Elderly ◽  
Posterior Arch ◽  
Age Group ◽  
Physical Medicine ◽  
Ponticulus Posticus ◽  
Lateral Cephalograms ◽  
Orthodontic Patients

Research background. Vertebral artery relation with atlas anatomical variations can lead to sensomotor disorders of head and neck, and vertebrobasilar insuffciency. Kimmerle’s anomaly, a bony ring around vertebral artery, is also known as a risk factor for physical medicine procedures. To the best of our knowledge, this is the frst study of Ponticulus posticus prevalence in Lithuania. Aim. The research aim was to investigate the prevalence of skeletotopy variations of the posterior arch and vertebral artery among Lithuanian orthodontic patients of various ages and both genders. Research methods. We randomly selected 870 digital lateral cephalograms of Lithuanian orthodontic patients of various ages and both genders. 706 images with good visualization of VA bony socket shadow on the superior surface of the atlas posterior arch were chosen for the investigation. According to the degree of depth of the bony socket we categorized them into three variations: sulcus, groove and bony ring. If contours around VA of bony arch were equal or greater than 180°, we included those cases into the group of bony groove. Research results. We estimated predominance of sulcus (67.6%) of bony socket variations. A bony groove of various depths was found in 24.0% and a bony ring was found in 7.5% of the subjects studied. Vertebral artery groove was found to be more prevalent in females than in males and bony ring was more common in males than in females, but there was no signifcant difference (p > 0.05). Statistically signifcant predominace of bony ring in the age group of 17–20 years (13.2%) was observed and it was higher than in the age group of 8–16 years (5.1%) (p < 0.05). Conclusions. 1. Variations of bony socket including sulcus, groove, and bony ring (Kimmerle’s anomaly) develop in adolescence when ossifcation is most active. 2. The bony ring and semi open groove, which limit mobility of distal part of the vertebral artery, can be a risk factor of physical medicine procedures, especially in the elderly, whose artery walls are less elastic.Keywords: Ponticulus posticus, Kimmerle’s anomaly, atlas, vertebral artery, manual therapy of neck.

The Feasibility of Microscope-Assisted “Free-Hand” C1 Lateral Mass Screw Insertion Without Fluoroscopy

Spine ◽  
2008 ◽  
Vol 33 (9) ◽  
pp. 1042-1049 ◽  
Author(s):  
Gabriel Liu ◽  
Jacob M. Buchowski ◽  
Hongxing Shen ◽  
Jin Sup Yeom ◽  
K Daniel Riew
Keyword(s):  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
C1 Lateral Mass Screw

C1 Lateral Mass Screw Insertion With Protection of C1-C2 Venous Sinus

Spine ◽  
2010 ◽  
Vol 35 (21) ◽  
pp. E1133-E1136 ◽  
Author(s):  
Jie Pan ◽  
Lijun Li ◽  
Lie Qian ◽  
Jun Tan ◽  
Guixin Sun ◽  
...  
Keyword(s):  
Venous Sinus ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
C1 Lateral Mass Screw

scholarly journals Posterior Subaxial Cervical Spine Screw Fixation: A Review of Techniques

2018 ◽  
Vol 8 (7) ◽  
pp. 751-760 ◽  
Author(s):  
Andrei Fernandes Joaquim ◽  
Marcelo Luis Mudo ◽  
Lee A. Tan ◽  
K. Daniel Riew
Keyword(s):  
Cervical Spine ◽  
Literature Review ◽  
Screw Fixation ◽  
Surgical Techniques ◽  
Pedicle Screw Fixation ◽  
Lateral Mass ◽  
Modified Technique ◽  
Screw Insertion ◽  
Subaxial Cervical Spine ◽  
Fixation Techniques

Study Design: A narrative literature review. Objectives: To review the surgical techniques of posterior screw fixation in the subaxial cervical spine. Methods: A broad literature review on the most common screw fixation techniques including lateral mass, pedicle, intralaminar and transfacet screws was performed on PubMed. The techniques and surgical nuances are summarized. Results: The following techniques were described in detail and presented with illustrative figures, including (1) lateral mass screw insertion: by Roy-Camille, Louis, Magerl, Anderson, An, Riew techniques and also a modified technique for C7 lateral mass fixation; (2) pedicle screw fixation technique as described by Abumi and also a freehand technique description; (3) intralaminar screw fixation; and finally, (4) transfacet screw fixation, as described by Takayasu, DalCanto, Klekamp, and Miyanji. Conclusions: Many different techniques of subaxial screw fixation were described and are available. To know the nuances of each one allows surgeons to choose the best option for each patient, improving the success of the fixation and decrease complications.

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