Seven Years of Experience With C2 Translaminar Screw Fixation: Clinical Series and Review of the Literature

Dorward, Ian G.; Wright, Neill M.

doi:10.1227/neu.0b013e318212a4d7

Cited by 68 publications

(64 citation statements)

References 42 publications

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“…The advantage of C-2 translaminar screw placement is the small risk of VA injury. 2,9,11 In C1A, a VA anomaly may also be seen with a smaller C-2. Therefore, the screw insertion procedure should be more carefully chosen than usual to avoid serious vascular complications.…”

Section: Discussionmentioning

confidence: 97%

Radiographic measurements of C-2 in patients with atlas assimilation

Aoyama

Yasuda

Yamahata

et al. 2014

SPI

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Object The object of this study was to evaluate the radiographic characteristics of C-2 using multiplanar CT measurements for anchor screw placement in patients with C-1 assimilation (C1A). Insertion of a C-2 pedicle screw in the setting of C1A is relatively difficult and technically demanding, and there has been no report about the optimal sizes of the pedicles and laminae of C-2 for screw placement in C1A. Methods An institutional database was searched for all patients who had undergone cervical CT scanning and cervical spine surgery between April 2006 and December 2012. Two neurosurgeons reviewed the CT scans from 462 patients who met these criteria, looking for C1A and other anomalies of the craniocervical junction such as high-riding vertebral artery (VA), basilar invagination, and VA anomaly. The routine axial images were reloaded on a workstation, and reconstruction CT images were used to measure parameters: the minimum width of bilateral pedicles and laminae and the length of bilateral laminae of the atlas. Results Seven patients with C1A were identified, and 14 sex-matched patients without C1A were randomly selected from the same database as a control group. The mean minimum pedicle width was 5.21 mm in patients with C1A and 7.17 mm in those without. The mean minimum laminae width was 5.29 mm in patients with C1A and 6.53 mm in controls. The mean minimum pedicle and laminae widths were statistically significantly smaller in the patients with C1A (p < 0.05). Conclusions In patients with C1A, the C-2 bony structures are significantly smaller than normal, making C-2 pedicle screw or translaminar screw placement more difficult.

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Section: Discussionmentioning

confidence: 97%

Radiographic measurements of C-2 in patients with atlas assimilation

Aoyama

Yasuda

Yamahata

et al. 2014

SPI

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“…Many reports showing its feasibility originated from Caucasians [3,4,9,22] and mainly conWned to C2 level. The largest single-surgeon series using translaminar screw Wxation was recently reported by Dorward and Wright [7]. In their series, they reported that C2 translaminar screws were successfully placed in 103 patients without any incidence of vascular or neurological complications, with only one instrumentation failure or pseudoarthrosis observed.…”

Section: Discussionmentioning

confidence: 99%

Translaminar screw fixation of the cervical spine in Asian population: feasibility and safety consideration based on computerized tomographic measurements

Yusof

Shamsi

2011

Surg Radiol Anat

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“…17) in 2004 [70]. Since then, many authors have reported both the anatomical study and clinical application of this technique [71][72][73][74][75]. In this technique, screws are inserted into the lamina of C2 in a crossed trajectory and then connected with rods to C1 lateral mass screws, C1 pedicle screws, or even the C1 locking plate [29].…”

Section: C2 Translaminar Screwmentioning

confidence: 99%

“…Thus, the C2 translaminar screw technique is considered to be a viable salvage in failed C2 pedicle insertion and in cases of high-riding anomalous vertebral arteries [77]. Excellent clinical outcomes of this technique have been reported in many studies recently [73][74][75].…”

Section: C2 Translaminar Screwmentioning

confidence: 99%