Document Detail


C1-2 transarticular screw fixation in high-riding vertebral artery: suggestion of new trajectory.
MedLine Citation:
PMID:  17912126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A significant drawback of atlantoaxial transarticular screw fixation is a potential risk of vertebral artery injury, especially with a high-riding type. The authors propose a relatively safe trajectory in cases of high-riding vertebral artery by using the 3-dimensional computerized tomography image reconstruction programs. Twelve consecutive patients with a pathologic condition in atlantoaxial complex were prospectively analyzed. Five other patients, whose high-riding vertebral arteries were incidentally found during the 3-dimensional computerized tomography performance for other cervical pathologic conditions, were also included. The preoperative screw simulation images, convergence angle, and caudal tilting angle for each screw were obtained from each patient. Of 17 subjects, 7 had high-riding vertebral artery unilaterally and 1 had bilaterally. All 12 patients with pathologic atlantoaxial complex, including 2 unilateral and 1 bilateral high-riding vertebral artery, had atlantoaxial transarticular screw fixation. For these 3 patients, the entry point and the trajectory for screw were moved more superiorly and medially as in cases with C2 pedicle screwing. The mean convergence angle and caudal tilt angle obtained during screw simulation for patients with high-riding vertebral arteries was 17.6 and 38 degrees compared with 21 and 53.3 degrees for patients with normal course of vertebral artery. It was possible to insert transarticular screws safely in patients with high-riding vertebral artery guided by preoperative screw insertion simulation program.
Authors:
June Ho Lee; Tae-Ahn Jahng; Chun Kee Chung
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  20     ISSN:  1536-0652     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-03     Completed Date:  2008-01-10     Revised Date:  2008-06-17    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  499-504     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid / radiography,  surgery*
Atlanto-Axial Joint / injuries*
Bone Screws
Cohort Studies
Female
Fracture Fixation / instrumentation,  methods*
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Odontoid Process / injuries*
Spinal Injuries / radiography,  surgery*
Tomography, X-Ray Computed
Treatment Outcome
Vertebral Artery / radiography*
Comments/Corrections
Comment In:
J Spinal Disord Tech. 2008 Feb;21(1):76-7   [PMID:  18418142 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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