Atlas (C1) lateral mass screw placement using the intersection between lateral mass and inferomedial edge of the posterior arch: a cadaveric study.
Eur Spine J
; 31(12): 3443-3451, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-36117232
ABSTRACT
PURPOSE:
To compare the Atlas (C1) lateral mass screw placement between screw trajectories of 0° and 15° medial angulation while using the intersection between lateral mass and inferomedial edge of the posterior arch.METHODS:
Forty-eight Atlas lateral masses were prepared and divided into 2 groups Group 1; screws inserted at 3 mm lateral to the reference point with screw trajectory of 0° angulation(N = 24) and Group 2; those inserted with screw trajectory of 15° medial angulation(N = 24). We evaluated the atlas anatomy, screw purchase and the presence of any breaches using CT scan.RESULTS:
The radiographic parameters for Groups 1 and 2 were found statistically different (p-value < 0.05) bilateral intraosseous screw lengths (17.92 ± 1.47 mm. vs. 20.71 ± 2.4 mm.), bilateral screw length (29.92 ± 1.72 mm. vs. 33.13 ± 1.78 mm.), left screw medial angulation (x°) (0.67° ± 0.78° vs.14.17° ± 3.51°), right screw medial angulation (y°) (0.83° ± 1.03° vs.14.25° ± 2.53°) and bilateral screw medial angulation (0.75° ± 0.9° vs. 14.21° ± 2.99°). Twenty-two screws (91.67%) using the 0° medial angulation and nineteen screws (79.17%) using the 15° medial angulation had no cortical violations (Grade 0). However, two screws (8.33%) with 0° medial angulation and five screws (20.83%) with 15° medial angulation had breach less than 2 mm (Grade 1). There were no screws with breach between 2 and 4 mm (Grade 2) or greater than 4 mm. (Grade 3).CONCLUSION:
A starting point of 3-mm lateral to the intersection between lateral mass and inferomedial edge of the Atlas posterior arch can be safely and effectively used to insert C1 lateral mass using both 0° and 15° medial angulation.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Articulação Atlantoaxial
/
Atlas Cervical
/
Fusão Vertebral
Limite:
Humans
Idioma:
En
Revista:
Eur Spine J
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Tailândia