Quantitative Anatomy of the Second Cervical Vertebra

Doherty, Brian J.; Heggeness, Michael H.

doi:10.1097/00007632-199503010-00002

Cited by 57 publications

(47 citation statements)

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“…In the present study, screw length was measured as the line through anterior-inferior point of the body of axis to odontoid tip, and it represents real screw trajectory and screw angle. In our study, screw length is 37.6 mm, and this result is well correlated with the literature [5,10]. Xu et al reported that a lateral X-ray may not be reliable in determining the optimal screw length but it could be valuable in directing accurate screw angle in the sagittal plane [20].…”

Section: Discussionsupporting

confidence: 88%

“…Likewise, long screws may perforate the odontoid tip and could lead to vertebral artery and neural tissue damage. The body of axis and odontoid height was reported to be 37.8 mm by Heller et al [10], and 39.9 mm by Doherty et al [5]. The body of axis and odontoid height does not represent correct screw length because they did not use the landmarks of real screw trajectory for anterior odontoid screw fixation.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical study of axis for odontoid screw thickness, length, and angle

et al. 2008

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Anterior odontoid screw fixation is a safe and effective method for treatment of odontoid fractures. The screw treads should fit into the odontoid medulla, should pass the fracture line, and should pull fractured odontoid tip against body of axis in order to achieve optimum screw placement and treatment. This study has demonstrated optimal anterior odontoid screw thickness, length, and optimal angle for safe and strong anterior odontoid screw placement. Dry bone axis vertebrae were evaluated by direct measurements, X-ray measurements, and computerized tomography (CT) measurements. The screw thickness (inner diameter of the odontoid) was measured as well as screw length (distance between anterior-inferior point body of axis and tip of odontoid), and screw angle (the angle between basis of axis and tip of odontoid). The inner diameter of odontoid bone was measured as 6.5 ± 1.9 mm, the screw length was 37.6 ± 3.3 mm, and the screw angle was 62.4 ± 4.7 on CT. There was no statistical difference between X-ray and CT in the measurements of screw thickness and angle. X-ray and CT measurements are both safe methods to determine the inner odontoid diameter and angle preoperatively. Screw length should be measured on CT only. To provide safe and strong anterior odontoid screw fixation, screw thickness, length, and angle should be known preoperatively, and these can be measured on X-ray and CT.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Anatomical study of axis for odontoid screw thickness, length, and angle

et al. 2008

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“…The external surface anatomy of C2 studied and well described previously in many anatomical studies [2,3,6,7,8,10]. But the internal anatomy of the vertebral bones, especially internal trabecular anatomy of C2 was studied by a few published articles in the aspect of biomechanical properties and the segmental anatomy [5].…”

Section: Discussionmentioning

confidence: 83%

The borders of the odontoid process of c2 in adults and in children including the estimation of odontoid/body ratio

et al. 2005

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“…As a reference study for definition of paramaters served the study done by Xu [18], in case of some parameters missing, studies by Doherty, Sengul and Singla were followed [15,24,27].…”

Section: Spinal Canal Inferior Depth Scdimentioning

confidence: 99%

“…Some of the researches devoted themselves to measure the pedicle parameters for transpedicular crew fixation [8,[17][18][19][20][21][22]. The previous studies obtained morphometric parameters either from CT scans or radiographs [10,16,17,23] or by direct measurement performed on cadavers [15,18,[24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Morphometric Analysis of Human Second Cervical Vertebrae (Axis)

Haiblikova

Winkelstein

et al. 2017

J Spine

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Possessing an odontoid process and unique superior articular facets, the axis vertebra morphometry significantly differs from morphometry of other cervical vertebrae. The fractures of axis, especially its dens, are very common and surgeries highly risky. Knowledge of the axis dimensions is essential not only for preclinical studies, diagnosis of spinal cord diseases, planning of the surgeries but also for correct selection and insertion of surgical instruments or vertebral implants design. Many quantitative studies of the second cervical vertebra have been performed, yet still lacking the area parameters determination and precision of three-dimension in vivo measurement. Vertebral dimensions are reported to vary among populations, although there are very little studies examining Caucasian specimen.This study aims to provide three-dimensional in vivo morphometric analysis of the axis vertebra as well as comparison to the previous studies. The clinically relevant vertebral dimensions were measured on the threedimensional model reconstruction of CT scans providing high accuracy. Five human second cervical vertebrae were investigated (Caucasian males) and linear, area and angular dimensions were measured.The data on vertebral body dimensions were best fitting Doherty and Naderi measurement. The vertebra body anterior height was established to be 26.2 mm and the posterior height 21.4 mm. The dens parameters were similar to those presented by Doherty. Doherty also reported large variation in the dens sagittal angle which was observed in the present study as well. The dens height was determined to be 17.8 mm which is significantly greater compared to the previous studies. The smallest height among specimens was reported to be 17.0 mm. The smallest anteroposterior or transverse diameter of the dens measured was the upper depth, 9.4 mm. The smallest and biggest areas of dens were measured to be 79.0 mm 2 and 121.6 mm 2 . The superior articular facet area with mean value 211.2 mm 2 was observed to be significantly bigger than the inferior area, 141.2 mm 2 . The mean sagittal angle of the inferior facet area was assessed to be 42.1° and the mean frontal angle of the superior articular facet 69.3°. The parameters of articular facets measured by Xu correspond to the present study. Due to the vertebral body enlargement in the inferior part of vertebra, the spinal canal superior depth,18.0 mm, was observed to be bigger than its inferior depth, 16.2 mm. In case of the spinal canal depth, Sengul measured values considerably greater than other studies. However, Singla, Gosavi and Xu presented the parameters very similar to the present study. Spinal canal width was measured to be 24.4 mm supporting the measurement done by Sengul which is 24.7 mm.The measured vertebral dimensions can be used either for development of instrumentation, preclinical planning of surgeries, implant design or as the reference values for evaluation and diagnosis of various clinical conditions.

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Quantitative Anatomy of the Second Cervical Vertebra

Cited by 57 publications

References 0 publications

Anatomical study of axis for odontoid screw thickness, length, and angle

Anatomical study of axis for odontoid screw thickness, length, and angle

The borders of the odontoid process of c2 in adults and in children including the estimation of odontoid/body ratio

Morphometric Analysis of Human Second Cervical Vertebrae (Axis)

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