Anatomic Considerations for the Pedicle Screw Placement in the First Cervical Vertebra

Ma, Xiangyang; Yin, Qudong; Wu, Zenghui; Xia, Hong; Liu, Jingfa; Zhang, Shizhen

doi:10.1097/01.brs.0000168546.17788.49

Cited by 99 publications

(93 citation statements)

References 10 publications

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“…However, little epidemiologic evidence for this exists. 31,55 A link between PP and head pain was observed by Wight et al 31 who noted a significant overrepresentation of the ring in chiropractic patients presenting with head pain without aura (ie, visual or auditory disturbances). Surgical excision of the PP appears to alleviate the symptoms of headache, vertigo, and basilar insufficiency.…”

Section: Discussionmentioning

confidence: 93%

“…Because putting a C1LMS in the classical entry point at the junction of the posterior arch and the lateral mass 10,54 causes significant bleeding from the epidural plexus and can possibly cause irritation to the C2 nerve root resulting in occipital neuralgia, some surgeons recommend placing the screw higher, starting in the posterior aspect of the posterior arch. 55 The purported benefits include longer bony purchase, increased rigidity, less C2 ganglion manipulation and postoperative neuralgia, and less intraoperative blood loss due to less disruption of the perineural venous plexus. 9,11,56 The broad posterior arch of the atlas is the best location for this modified screw placement.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Computed Tomography

Şekerci

Soylu

Arıkan

et al. 2015

Journal of Chiropractic Medicine

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Objective: This study evaluated the prevalence and morphologic characteristics of ponticulus posticus (PP) by using cervical 3-dimensional (3-D) cone-beam computed tomography (CBCT) scan images. Methods: This was a retrospective study conducted by selecting cervical 3-D CBCT images of 698 patients, which were examined for the presence and types of PP. Results: In 257 patients, 438 PPs, complete or partial, bilateral or unilateral, were identified on the 698 cervical 3-D CBCT scans; therefore, the prevalence was 36.8%. Bilateral complete PP and partial PP were observed in 6.3% and 16.2% of subjects, respectively. There was a significant difference in the prevalence between males and females (P = .001) and between the right and left sides between males and females, but not between age groups. Conclusion: Ponticulus posticus is a relatively common anomaly in this Turkish sample, which may have implications for those who perform clinical procedures on the upper cervical spine.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Computed Tomography

Şekerci

Soylu

Arıkan

et al. 2015

Journal of Chiropractic Medicine

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“…Since then, multiple studies have investigated the anatomy and feasibility of C1 pedicle screw placement [10][11][12][18][19][20][21][22]. Most investigations insisted that the mediolateral width at the isthmus of the C1 pedicle was large enough to insert a 3.5-mm diameter screw [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…However, controversy over the transverse direction of the C1 pedicle screw has existed for a long time [10][11][12]. Tan et al [10] suggested that the screw trajectory should be perpendicular to the coronal plane, whereas Ma et al [11] recommended medial inclination by about 10°, because complications such as neurovascular injury could arise from the lateral mass screw technique [13,14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of perpendicular to the coronal plane versus medial inclination for atlas pedicle screw insertion: an anatomic and radiological study in human cadavers

Tang

Wang

et al. 2015

International Orthopaedics (SICOT)

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Purpose To ascertain the anatomic and radiological parameters of the atlas (C1) pedicle and to explore a preferable method of C1 pedicle screw insertion. Methods Thirty-four conserved human cadaveric cervical spines (20 males, 14 females) underwent computed tomography (CT) scanning. Trajectories P (perpendicular to the coronal plane) and I (with medial inclination) were designed for each C1 pedicle on CT images. External pedicle wall width, medullary cavity width, transverse angle, and optimal entry point along each trajectory were measured. Cortical screws of 3.5 mm in diameter were inserted into C1 pedicles along trajectory P and I, respectively, and wall perforation was assessed (post-operative CT scanning). Results The external pedicle wall width and medullary cavity width along trajectory I were significantly wider than trajectory P (P<0.01). Although external pedicle wall widths were all greater than 3.5 mm, medullary cavity width<3.5 mm was found in 16.1 % pedicles along trajectory P and only 2.9 % along trajectory I. Transverse angle was 21.8°along trajectory I and 0°along trajectory P. Optimal entry point of trajectory I was 4.1 mm lateral from that of trajectory P. The lateral wall perforation rate was significantly lower along trajectory I than trajectory P (P<0.05). Conclusions C1 pedicle screw trajectory with medial inclination and more lateral entry points yielded wider medullary cavity width than that perpendicular to the coronal plane, and might minimize lateral wall perforation.

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“…The same technique was employed in 2014 by Ma et al for IAAD. 143 However, in 2010, Wu et al could access the corresponding field with the tubular approach. 144 The entry incision was high cervical, medical to sternocleidomastoid.…”

Section: History Of Surgical Intervention In Iaadmentioning

confidence: 99%

Os Odontoideum: Review Article

Rahimizadeh¹

2017

Orthop Res Traumatol Open J

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Os odontoideum (OO) is defined as an ossicle with circumferential smooth margins and no osseous continuity with the body of axis. While the size of the ossicle is variable, it has a smooth surface, therefore, the cause of this condition has been presumed to be both congenital and traumatic. The possible cause of this condition has been implicated in its underlying etiology. However, patients with this condition may be asymptomatic or may be symptomatic of a variety of neurological deficits and vascular dysfunctions. The treatment of both the asymptomatic and symptomatic characteristics of this condition has undergone changes over the past few decades. The most challenging issue encountered is the management of OO with irreducible atlantoaxial dislocation. This outlines the objective of our discussion to examine the aforementioned subject extensively and review the appropriate potential strategies for the treatment of this condition.

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Anatomic Considerations for the Pedicle Screw Placement in the First Cervical Vertebra

Cited by 99 publications

References 10 publications

Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Computed Tomography

Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Computed Tomography

Comparison of perpendicular to the coronal plane versus medial inclination for atlas pedicle screw insertion: an anatomic and radiological study in human cadavers

Os Odontoideum: Review Article

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