Radiographic measurement and the screw placement strategies of axis quadricortical pedicle screw

Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (1) : 53-58.

Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (1) : 53-58. DOI: 10.13418/j.issn.1001-165x.2016.01.015

Radiographic measurement and the screw placement strategies of axis quadricortical pedicle screw

  • ZHOU Xin 1,2,  MA Xiang-yang 2,  YANG Jin-cheng 2,  QIU feng 2,  XIAO yao-sheng 2,  HU hai-sheng 2
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Abstract

Objective To study the feasibility of screw placement strategies and the technique of axis quadricortical pedicle screw.  Methods 49 males and 43 females with normal cervical spine were included. At the C2 pedicle level of MRI images, we marked the tangent of pedicle medial wall which was parallel with central axis of C2 pedicle, and measured the distance between the tangent and spinal cord and the distance between the tangent and dura mater. At the same time, the tangent of C2 spinal canal medial wall which was parallel with sagittal axis of C2 was marked too, also we checked the distance between the tangent and spinal cord and the distance between the tangent and dura mater. Spinal cord diameter, spinal canal diameter and other associated parameters were recorded too. Result No statistical difference occurred between same sex.The mean distance between C2 pedicle medial wall and spinal cord was (male 9.05 mm, female 8.57 mm); The mean distance between C2 pedicle medial wall and dura mater was (male 5.04 mm, female 4.76 mm); The mean distance between the C2 spinal canal medial wall and spinal cord was (male 7.14 mm, female 6.70 mm); The mean distance between the C2 spinal canal medial wall and dura mater was (male 3.28 mm, female 3.28 mm).     Conclusion    At the C2 level, the space between the C2 spinal canal medial wall and dura mater was safe for C2 quadricortical pedicle screw;However, there were individual differences among patients.Therefore, different screw placement strategies should be applied based on different situations.

Key words

 Axis pedicle / Quadricortical pedicle screw / Tricortical pedicle screw / MRI

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Radiographic measurement and the screw placement strategies of axis quadricortical pedicle screw[J]. Chinese Journal of Clinical Anatomy. 2016, 34(1): 53-58 https://doi.org/10.13418/j.issn.1001-165x.2016.01.015

References

[1]  Ito Z, Higashino K, Kato S, et al. Pedicle screws can be 4 times stronger than lateral mass screws for insertion in  the midcervical spine: a biomechanical study on strength of fixation[J]. J Spinal Disord Tech, 2014,27(2):80-85.
[2]  Jones E L, Heller J G, Silcox D H, et al. Cervical pedicle screws versus lateral mass screws. Anatomic feasibility and biomechanical comparison[J]. Spine (Phila Pa 1976), 1997,22(9):977-982.
[3]  Li X, Ai F, Xia H, et al. Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients[J]. Eur Spine J, 2014,23(8):1712-1719.
[4]  侯黎升, 贾连顺, 谭军, 等. 枢椎各结构的解剖学部位研究[J]. 中国临床解剖学杂志, 2005, 23(1):44-48.
[5]  马向阳, 尹庆水, 吴增晖, 等. 枢椎椎弓根螺钉进钉点的解剖定位研究[J]. 中华外科杂志, 2006, 44(8):562-564.
[6]  吴增晖, 马向阳, 尹庆水, 等. 枢椎椎弓根螺钉固定可行性的 CT 测量研究[J]. 中国临床解剖学杂志, 2007, 25(5):518-520.
[7]  Igarashi T, Kikuchi S, Sato K, et al. Anatomic study of the axis for surgical planning of transarticular screw fixation[J]. Clin Orthop Relat Res, 2003(408):162-166.
[8]  Xu R, Nadaud MC, Ebraheim NA, et al. Morphology of the second cervical vertebra and the posterior projection of the C2 pedicle axis[J]. Spine (Phila Pa 1976), 1995,20(3):259-263.
[9] Leconte P. Fracture et luxation des deux premieres vertebres cervicales.In: Judet R.(ed.)Luxation Congenitale de la Hanche. Fractures du Cou-de-pied Rachis Cervical. Actualites de Chirurgie Orthopedique de l'Hopital Raymond-Poincare, vol 3. pp. 147-166. Masson et Cie, Pairs(1964)
[10]Alosh H, Parker SL, McGirt MJ, et al. Preoperative radiographic factors and surgeon experience are associated with cortical breach of C2 pedicle screws[J]. J Spinal Disord Tech, 2010, 23(1):9-14.
[11]Bydon M, Mathios D, Macki M, et al. Accuracy of C2 pedicle screw placement using the anatomic freehand technique[J]. Clin Neurol Neurosurg, 2014,125:24-27.
[12]Sciubba DM, Noggle JC, Vellimana AK, et al. Radiographic and clinical evaluation of free-hand placement of C-2 pedicle screws. Clinical article[J]. J Neurosurg Spine, 2009,11(1):15-22.

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