[논문]Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability

Chun, Hyoung-Joon; Bak, Koang-Hum

doi:10.3340/jkns.2011.49.6.351

Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability 원문보기

Journal of Korean Neurosurgical Society = 대한신경외과학회지, v.49 no.6, 2011년, pp.351 - 354

Chun, Hyoung-Joon (Department of Neurosurgery, Hanyang University Medical Center) , Bak, Koang-Hum (Department of Neurosurgery, Hanyang University Medical Center)

Abstract ▼ AI-Helper

Objective : This investigation was conducted to evaluate a new, safe entry point for the C2 pedicle screw, determined using the anatomical landmarks of the C2 lateral mass, the lamina, and the isthmus of the pars interarticularis. Methods : Fifteen patients underwent bilateral C1 lateral mass-C2 pedicle screw fixation, combined with posterior wiring. The C2 pedicle screw was inserted at the entry point determined using the following method : 4 mm lateral to and 4 mm inferior to the transitional point (from the superior end line of the lamina to the isthmus of the pars interarticularis). After a small hole was made with a high-speed drill, the taper was inserted with a 30 degree convergence in the cephalad direction. Other surgical procedures were performed according to Harm's description. Preoperatively, careful evaluation was performed with a cervical X-ray for C1-C2 alignment, magnetic resonance imaging for spinal cord and ligamentous structures, and a contrast-enhanced 3-dimensional computed tomogram (3-D CT) for bony anatomy and the course of the vertebral artery. A 3-D CT was checked postoperatively to evaluate screw placement Results : Bone fusion was achieved in all 15 patients (100%) without screw violation into the spinal canal, vertebral artery injury, or hardware failure. Occipital neuralgia developed in one patient, but this subsided after a C2 ganglion block. Conclusion : C2 transpedicular screw fixation can be easily and safely performed using the entry point of the present study. However, careful preoperative radiographic evaluation, regardless of methods, is mandatory.

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참고문헌 (27)

Brooks AL, Jenkins EB : Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 60 : 279-284, 1978
Claybrooks R, Kayanja M, Milks R, Benzel E : Atlantoaxial fusion: a biomechanical analysis of two C1-C2 fusion techniques. Spine J 7 : 682-688, 2007

상세보기
Dickman CA, Sonntag VK : Posterior C1-C2 screw fixation for atlanto-axial arthrodesis. Neurosurgery 43 : 275-281, 1998

상세보기
Ebraheim N, Rollins JR Jr, Xu R, Jackson WT : Anatomical consideration of C2 pedicle screw placement. Spine (Phila Pa 1976) 21 : 691-694, 1996
Ebraheim NA, Fow J, Xu R, Yeasting RA : The location of the pedicle and pars interarticularis in the axis. Spine (Phila Pa 1976) 26 : E34-E37, 2001
Gallie WE : Fractures and dislocations of the cervical spine. Am J Surg 46 : 495-499, 1939

상세보기
Goel A, Desai KI, Muzumdar DP : Atlantoaxial fixation plate and screw method : a report of 160 treated patients. Neurosurgery 51 : 1351-1357, 2002

상세보기
Grob D, Jeanneret B, Aebi M, Markwalder TM : Atlanto-axial fusion with transarticular screw fixation. J Bone Joint Surg Br 73 : 972-976, 1991
Gunnarsson T, Massicotte EM, Govender PV, Raja Rampersaud Y, Fehlings MG : The use of C1 lateral mass screws in complex cervical spine surgery : indications, techniques, and outcome in a prospective consecutive series of 25 cases. J Spinal Disord Tech 20 : 308-316, 2007

상세보기
Harms J, Melcher RP : Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976) 26 : 2467-2471, 2001
Hue YH, Chun HJ, Yi HJ, Oh SH, Oh SJ, Ko Y : Unilateral posterior atlantoaxial transarticular screw fixation in patients with atlantoaxial instability : Comparison with bilateral method. J Korean Neurosurg Soc 45 : 164-168, 2009

원문보기 상세보기
Jeanneret B : Posterior transarticular screw fixation of C1-C2. Tech Orthop 1 : 49-59, 1994
Karaikovic EE, Daubs MD, Madsen RW, Gaines RW Jr : Morphologic characteristics of human cervical spines. Spine (Phila Pa 1976) 22 : 493-500, 1997
Lapsiwala SB, Anderson PA, Oza A, Resnick DK : Biomechanical comparison of four C1 to C2 rigid fixative techniques : anterior transarticular, posterior transarticular, C1 to C2 pedicle and C1 to C2 intralaminar screws. Neurosurgery 58 : 516-521, 2006

상세보기
Lee JH, Jahng TA, Chung CK : C1-2 transarticular screw fixation in high-riding vertebral artery : suggestion of new trajectory. J Spinal Disord Tech 20 : 499-504, 2007

상세보기
Magerl F, Seeman PS : Stable posterior fusion of the atlas by transarticular screw fixation in Kehr P, Weidner A (eds) : Cervical Spine I. New York, NY : Springer-Verlag, 1987
Mandel IM, Kambach BJ, Petersilge CA, Johnstone B, Yoo JU : Morphologic considerations of C2 isthmus dimensions for placement of transarticular screws. Spine (Phila Pa 1976) 25 : 1542-1547, 2000
Menendez JA, Wright NM : Techniques of posterior C1-C2 stabilization. Neurosurgery 60 : S103-S111, 2007
Neo M, Sakamoto T, Fujibayashi S, Nakamura T : A safe screw trajectory for atlantoaxial transarticular fixation achieved using an aiming device. Spine (Phila Pa 1976) 30 : E236-E242, 2005
Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K : Cervical human vertebrae-Quantitative three dimentional anatomy of the middle and lower regions. Spine (Phila Pa 1976) 16 : 861-869, 1991
Starr JK, Eismont FJ : Atypical hangman's fracture. Spine (Phila Pa 1976) 18 : 1954-1957, 1993
Stulik J, Vyskocil T, Sebesta P, Kryl J : Atlantoaxial fixation using the polyaxial screw-rod system. Eur Spine J 16 : 479-484, 2007
Suchomel P, Stutlik J, Klezl Z, Chrobok J, Lukas R, Krbec M, et al. : Transarticular fixation of C1-C2 : a multicenter retrospective study. Acta Chir Orthop Traumatol Cech 71 : 6-12, 2004

상세보기
Takahashi J, Shono Y, Nakamura I, Hirabayashi H, Kamimura M, Ebara S, et al. : Computer-assisted screw insertion for cervical disorders in rheumatoid arthritis. Eur Spine J 16 : 485-494, 2007
Tucker HH : Technical report : method of fixation of subluxed or dislocated cervical spine below C1-C2. Can J Neurol Sci 2 : 381-382, 1975

상세보기
Wright NM : Posterior C2 fixation using bilateral, crossing C2 laminar screws : Case series and technical note. J Spinal Disord Tech 17 : 158-162, 2004

상세보기
Xu R, Nadaud MC, Ebraheim NA, Yeasting RA : Morphology of the second cervical vertebra and the posterior projection of the C2 pedicle axis. Spine (Phila Pa 1976) 20 : 259-263, 1995

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Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability 원문보기

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