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

Abstract

Translaminar fixation using a 3.5 screw should be attempted with caution in Asian population. Pre-operative CT scan evaluation is mandatory before translaminar screw fixation is attempted.

Posterior atlantoaxial fixation: a review of all techniques

“…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].…”

Use of intraoperative fluoroscopy for the safe placement of C2 laminar screws: technical note

“…This allows for the impromptu use of laminar screws as a salvage maneuver for C2 pedicle and pars screws even by experienced surgeons, or as a safety guard against errant screw placement by the occasional surgeon. As further advances in translaminar screws develop, including the lower cervical levels [1,4,16] where the canal is less capacious, modifications to our technique may help promote the safe placement of screws at these additional levels.…”

The risk of translaminar screw fixation to the transverse foramen of the lower cervical spine: a computed tomography study

“…and they reported C4 and C5 never accepted bilateral translaminar screw, C3 and C6 accepted bilateral screws at low placement rates (8–24%), C7 accepted bilateral placement at a high rate (96% men, 84% women). However, a cadaveric study of 37 spines conducted by Yusof MI et al 25. showed that approximately 30, 17, 18, 49 and 100% of patients may receive translaminar screw fixation at C3–C7, respectively.…”

“…In the sagittal plane, laminar height (LH) was measured as the height of the junction of the lamina and the spinous process (Fig. 2)132425. For unilateral placement, the thickness of lamina should be greater than 3.5-mm, and for placing the bilateral screws, we assumed a minimum required laminar height of 7 mm.…”

“…Recent years, translaminar screw technique has been increasingly used in the lower cervical spine and upper thoracic spine, and previous studies have demonstrated the feasibility of translaminar screw placement in the lower cervical laminae10131415161718192021222324252627. The second segment of vertebral artery courses through the transverse foramen (TF) from C6 to C1 (3.95% of cases enter to the TF at the level of C7)2829.…”