IMPORTANCE OF THE C1 ANTERIOR TUBERCLE DEPTH AND LATERAL MASS GEOMETRY WHEN PLACING C1 LATERAL MASS SCREWS

Neurosurgery ◽  
2009 ◽  
Vol 65 (5) ◽  
pp. 952-957 ◽  
Author(s):  
Scott D. Wait ◽  
Francisco A. Ponce ◽  
Kyle O. Colle ◽  
Phillip V. Parry ◽  
Volker K.H. Sonntag
Keyword(s):  
Lateral Mass ◽  
Lateral Mass Screws ◽  
Anterior Tubercle

Safe Zone for C1 Lateral Mass Screws: Anatomic and Radiological Study

2011 ◽  
Vol 2011 ◽  
pp. 311-312
Author(s):  
R. Riesenburger
Keyword(s):  
Safe Zone ◽  
Lateral Mass ◽  
Radiological Study ◽  
Lateral Mass Screws

Factors affecting lateral mass screw placement at C-7

2011 ◽  
Vol 14 (3) ◽  
pp. 405-411 ◽  
Author(s):  
Kalil G. Abdullah ◽  
Amy S. Nowacki ◽  
Michael P. Steinmetz ◽  
Jeffrey C. Wang ◽  
Thomas E. Mroz
Keyword(s):  
Sagittal Plane ◽  
Anatomical Variation ◽  
Axial Plane ◽  
Screw Placement ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Modified Technique ◽  
Modified Method ◽  
Starting Point ◽  
Lateral Mass Screws

Object The C-7 lateral mass has been considered difficult to fit with instrumentation because of its unique anatomy. Of the methods that exist for placing lateral mass screws, none particularly accommodates this anatomical variation. The authors have related 12 distinct morphological measures of the C-7 lateral mass to the ability to place a lateral mass screw using the Magerl, Roy-Camille, and a modified Roy-Camille method. Methods Using CT scans, the authors performed virtual screw placement of lateral mass screws at the C-7 level in 25 male and 25 female patients. Complications recorded included foraminal and articular process violations, inability to achieve bony purchase, and inability to place a screw longer than 6 mm. Violations were monitored in the coronal, axial, and sagittal planes. The Roy-Camille technique was applied starting directly in the middle of the lateral mass, as defined by Pait's quadrants, with an axial angle of 15° lateral and a sagittal angle of 90°. The Magerl technique was performed by starting in the inferior portion of the top right square of Pait's quadrants and angling 25° laterally in the axial plane with a 45° cephalad angle in the sagittal plane. In a modified method, the starting point is similar to the Magerl technique in the top right square of Pait's quadrant and then angling 15° laterally in the axial plane. In the sagittal plane, a 90° angle is taken perpendicular to the dorsal portion of the lateral mass, as in the traditional Roy-Camille technique. Results Of all the morphological methods analyzed, only a combined measure of intrusion of the T-1 facet and the overall length of the C-7 lateral mass was statistically associated with screw placement, and only in the Roy-Camille technique. Use of the Magerl technique allowed screw placement in 28 patients; use of the Roy-Camille technique allowed placement in 24 patients; and use of the modified technique allowed placement in 46 patients. No screw placement by any method was possible in 4 patients. Conclusions There is only one distinct anatomical ratio that was shown to affect lateral mass screw placement at C-7. This ratio incorporates the overall length of the lateral mass and the amount of space occupied by the T-1 facet at C-7. Based on this virtual study, a modified Roy-Camille technique that utilizes a higher starting point may decrease the complication rate at C-7 by avoiding placement of the lateral mass screw into the T1 facet.

Pedicle Screws Can be 4 Times Stronger Than Lateral Mass Screws for Insertion in the Midcervical Spine

2014 ◽  
Vol 27 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Zenya Ito ◽  
Kosaku Higashino ◽  
Satoshi Kato ◽  
Sung Soo Kim ◽  
Eugene Wong ◽  
...  
Keyword(s):  
Pedicle Screws ◽  
Lateral Mass ◽  
Lateral Mass Screws

Use of Spinous Processes to Determine the Optimal Trajectory for Placement of Lateral Mass Screws

2009 ◽  
Vol 22 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Qualls E. Stevens ◽  
Mohammad E. Majd ◽  
Keith A. Kattner ◽  
Cynthia L. Jones ◽  
Richard T. Holt
Keyword(s):  
Optimal Trajectory ◽  
Lateral Mass ◽  
Spinous Processes ◽  
Lateral Mass Screws

scholarly journals The use of intraoperative navigation for complex upper cervical spine surgery

2014 ◽  
Vol 36 (3) ◽  
pp. E5 ◽  
Author(s):  
Kern H. Guppy ◽  
Indro Chakrabarti ◽  
Amit Banerjee
Keyword(s):  
Cervical Spine ◽  
Navigation System ◽  
Surgical Navigation ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Upper Cervical Spine ◽  
Cervical Canal ◽  
Lateral Mass ◽  
Upper Cervical ◽  
Lateral Mass Screws

Imaging guidance using intraoperative CT (O-arm surgical imaging system) combined with a navigation system has been shown to increase accuracy in the placement of spinal instrumentation. The authors describe 4 complex upper cervical spine cases in which the O-arm combined with the StealthStation surgical navigation system was used to accurately place occipital screws, C-1 screws anteriorly and posteriorly, C-2 lateral mass screws, and pedicle screws in C-6. This combination was also used to navigate through complex bony anatomy altered by tumor growth and bony overgrowth. The 4 cases presented are: 1) a developmental deformity case in which the C-1 lateral mass was in the center of the cervical canal causing cord compression; 2) a case of odontoid compression of the spinal cord requiring an odontoidectomy in a patient with cerebral palsy; 3) a case of an en bloc resection of a C2–3 chordoma with instrumentation from the occiput to C-6 and placement of C-1 lateral mass screws anteriorly and posteriorly; and 4) a case of repeat surgery for a non-union at C1–2 with distortion of the anatomy and overgrowth of the bony structure at C-2.

Proposal for a new trajectory for subaxial cervical lateral mass screws

2018 ◽  
Vol 27 (11) ◽  
pp. 2738-2744 ◽  
Author(s):  
Samer Amhaz-Escanlar ◽  
Alberto Jorge-Mora ◽  
Teresa Jorge-Mora ◽  
Manuel Febrero-Bande ◽  
Maximo-Alberto Diez-Ulloa
Keyword(s):  
Lateral Mass ◽  
Lateral Mass Screws

scholarly journals Posterior spinal fusion using a unilateral C1 posterior arch screw and a C2 laminar screw for atlantoaxial fracture dislocation

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984927 ◽  
Author(s):  
Yuichi Ono ◽  
Naohisa Miyakoshi ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
Yoshinori Ishikawa ◽  
...  
Keyword(s):  
Pedicle Screws ◽  
Fracture Site ◽  
Fracture Dislocation ◽  
Posterior Arch ◽  
Lateral Mass ◽  
Laminar Screw ◽  
Upper Cervical ◽  
Lateral Mass Screws ◽  
The Right ◽  
C2 Laminar Screw

Introduction: C1 lateral mass screws and C2 pedicle screws are usually chosen to fix atlantoaxial (C1–C2) instability. However, there are a few situations in which these screws are difficult to use, such as in a case with a fracture line at the screw insertion point and bleeding from the fracture site. A new technique using a unilateral C1 posterior arch screw and a C2 laminar screw combined with a contralateral C1 lateral mass screws–C2 pedicle screws procedure for upper cervical fixation is reported. Case Report: A 24-year-old woman had an irreducible C1–C2 anterior dislocation with a type III odontoid fracture on the right side due to a traffic accident. The patient underwent open reduction and posterior C1–C2 fixation. On the left side, a C1 lateral mass screws and a C2 pedicle screws were placed. Because there was bleeding from the fracture site and a high-riding vertebral artery was seen on the right side, a C1 posterior arch screw and a C2 laminar screw were chosen. Eight months after the surgery, computed tomography scans showed healing of the odontoid fracture with anatomically correct alignment. Conclusions: Although there have been few comparable studies, fixation with unilateral C1 posterior arch screw–C2 laminar screw could be a beneficial choice for surgeries involving the upper cervical region in patients with fracture dislocation or arterial abnormalities.

Atlantoaxial stabilization using multiaxial C-1 posterior arch screws

2008 ◽  
Vol 9 (6) ◽  
pp. 522-527 ◽  
Author(s):  
Michael B. Donnellan ◽  
Ioannis G. Sergides ◽  
William R. Sears
Keyword(s):  
Clinical Results ◽  
Posterior Arch ◽  
Lateral Mass ◽  
Normal Anatomy ◽  
Novel Technique ◽  
Vertebral Arteries ◽  
Fixation Techniques ◽  
Atlantoaxial Fixation ◽  
Atlantoaxial Stabilization ◽  
Lateral Mass Screws

The authors present a novel technique of atlantoaxial fixation using multiaxial C-1 posterior arch screws. The technique involves the insertion of bilateral multiaxial C-1 posterior arch screws, which are connected by crosslinked rods to bilateral multiaxial C-2 pars screws. The clinical results are presented in 3 patients in whom anomalies of the vertebral arteries, C-1 lateral masses, and/or posterior arch of C-1 presented difficulty using existing fixation techniques with transarticular screws, C-1 lateral mass screws, or posterior wiring. The C-1 posterior arch screws achieved solid fixation and their insertion appeared to be technically less demanding than that of transarticular or C-1 lateral mass screws. This technique may reduce the risk of complications compared with existing techniques, especially in patients with anatomical variants of the vertebral artery, C-1 lateral masses, or C-1 posterior arch. This technique may prove to be an attractive fixation option in patients with normal anatomy.

Biomechanical Role of the C1 Lateral Mass Screws in Occipitoatlantoaxial Fixation

Spine ◽  
2016 ◽  
Vol 41 (22) ◽  
pp. E1312-E1318 ◽  
Author(s):  
Haibo Liu ◽  
Baocheng Zhang ◽  
Jianyin Lei ◽  
Xianhua Cai ◽  
Zhiqiang Li ◽  
...  
Keyword(s):  
Lateral Mass ◽  
Lateral Mass Screws
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