The Vertebral Artery Cave at C2: Anatomic Study with Application to C2 Pedicle Screw Placement
| Autor: | Christian Fisahn, Jens R. Chapman, Marc Moisi, Rod J. Oskouian, Andre Granger, Marios Loukas, R. Shane Tubbs, David Paulson, Shiveindra Jeyamohan, Joe Iwanaga |
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| Rok vydání: | 2016 |
| Předmět: |
Vertebral artery
Sensitivity and Specificity Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Cave Pedicle Screws Cadaver medicine.artery medicine Humans Pedicle screw Vertebral Artery Objective knowledge 030222 orthopedics geography Articular facet geography.geographical_feature_category business.industry Reproducibility of Results Anatomy musculoskeletal system humanities medicine.anatomical_structure Cervical Vertebrae Surgery Neurology (clinical) Anatomic Landmarks business 030217 neurology & neurosurgery Artery Cervical vertebrae |
| Zdroj: | World Neurosurgery. 94:368-374 |
| ISSN: | 1878-8750 |
| Popis: | Objective Knowledge of the course of the vertebral artery during instrumentation is of paramount importance. It has been shown that erosion of the C2 pedicle and body can occur due to pulsations of the adjacent vertebral artery. This often results in a "cave" for this segment of the artery. The descriptions of this anatomy are limited. The current study was performed with the hope that these data will be of use to spine surgeons during C2 instrumentation. Methods In 40 human adult C2 bone specimens, the position of the vertebral artery in relation to the undersurface of the superior articular facet, pedicle, and C2 body was observed. A classification system was used to better describe these relationships. Pedicle screws were then placed into selected examples of each type. Results We found type 0 specimens, with no cave, on 8 sides (10%). Types I, II, and III caves with minimal, moderate, and significant encroachment of the pedicle were observed on 40%, 35%, and 27.5% sides, respectively. Type IV caves with erosion into the lateral C2 body and undersurface of the superior articular facet were observed on 12.5% of sides. Although larger caves were found on left sides, this did not reach statistical significance. Pedicle screw placement for types III and IV were most likely to enter the vertebral artery cave ( P Conclusions Additional osteologic data regarding the course of the vertebral artery while within C2 may decrease morbidity during surgery in this region. |
| Databáze: | OpenAIRE |
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