Atlas instrumentation guided by the medial edge of the posterior arch: An anatomic and radiologic study
| Autor: | Abdulkarim Al-Rabie, Sami Aleissa, Abdulaziz H. Abobotain, Amro Al-Habib, Abdulrahman Albakr |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system Lateral mass atlas medial arch Computed tomography 03 medical and health sciences 0302 clinical medicine Atlas (anatomy) medicine Arch C1 inferior arch border medicine.diagnostic_test business.industry fungi atlas instrumentation Venous plexus Anatomy Cervical spine Sagittal plane Posterior arch Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis atlas lateral mass Original Article Neurology (clinical) lcsh:RC925-935 business Atlantoaxial instrumentation 030217 neurology & neurosurgery craniocervical instrumentation |
| Zdroj: | Journal of Craniovertebral Junction & Spine Journal of Craniovertebral Junction and Spine, Vol 8, Iss 2, Pp 97-102 (2017) |
| ISSN: | 0974-8237 |
| Popis: | Study Design: This was an interventional human cadaver study and radiological study. Objectives: Atlas instrumentation is frequently involved in fusion procedures involving the craniocervical junction area. Identification of the entry point at the center of atlas lateral mass (ALM) is challenging because of its rounded posterior surface and the surrounding venous plexus. This report examines using the medial edge of atlas posterior arch (MEC1) as a fixed and reliable anatomic reference to guide the entry point of ALM screws. Methods: Fifty, normal, cervical spine computed tomography studies were reviewed. ALM screw trajectories were planned at one point along MEC1 and another point 2 mm lateral to MEC1. Free-hand ALM instrumentation was performed in ten fresh human cadavers using the 2 mm entry point, with a sagittal trajectory parallel to atlas inferior arch (IAC1); three-dimensional imaging was then performed to confirm instrumentation accuracy. Results: The average ALM diameter was 12.35 mm. Inserting a screw using the entry point 2 mm lateral to MEC1 was closer to ALM midpoint than using the entry point along MEC1 (P < 0.0001). Twenty ALM screws were successfully inserted in the ten cadavers. No encroachments into the spinal canal or foramen transversarium occurred. However, two screws were superiorly directed and violated the occipitocervical joint; they were not parallel to IAC1. Conclusion: MEC1 provides a fixed and reliable landmark for ALM instrumentation. An entry point 2 mm point lateral to MEC1 is close to ALM midpoint. IAC1 also provides a guide for the sagittal trajectory. Attention to anatomic landmarks may help reduce complications associated with atlas instrumentation but should be verified in future clinical studies. |
| Databáze: | OpenAIRE |
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