Clinical and radiologic outcome of laminar screw at C2 and C7 for posterior instrumentation—review of 25 cases and comparison of C2 and C7 intralaminar screw fixation

Hong, Jae Taek; Yi, Jin Seok; Kim, Jong-Tae; Ji, Chul; Ryu, Kyung Sik; Park, Chun Kun

doi:10.1016/j.surneu.2009.06.010

Cited by 38 publications

(38 citation statements)

References 27 publications

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“…Limited case series have shown good clinical results with C-7 intralaminar screw fixation, [3][4][5] and its biomechanical viability was verified by Hong et al 4 Based on their in vitro biomechanical study, the C-7 intralaminar screw was stronger and provided more reproducible fixation than lateral mass screws, with the exception of lateral bending.…”

Section: Discussionmentioning

confidence: 99%

“…We used the technique for intralaminal C-7 screw placement as described by Hong et al 3,5 After dorsal exposure of the spinous process and lamina, the slope angle of the lamina was measured. The entry point for screws was at the spinolaminar junction, at which point a high-speed drill was used to open a small starter hole.…”

Section: Methodsmentioning

confidence: 99%

“…The screws were inserted manually without radiographic monitoring. [3][4][5] Data are expressed as mean ± SD and range.…”

Section: Methodsmentioning

confidence: 99%

“…6 The C-7 intralaminar screw technique was originally reported as a successful method for rigid fixation of C-7 in 11 patients by Hong et al in 2008. 3,5 Because this technique uses crossing screws placed directly into the lamina of C-7, this intralaminar screw method is useful for avoiding vascular structures, for example, the vertebral artery in the C-7 transverse foramen. This technique is simple, does not require the use of any navigational instruments, and is not limited by the position of known vascular structures.…”

mentioning

confidence: 99%

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Placement of C-7 intralaminar screws: a quantitative anatomical and morphometric evaluation

Şenoğlu¹,

Özkan

Çelık

2012

SPI

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Object Crossing laminar screws at C-7 have been recently described as a method for the fixation of C-7. In this study the authors measured locations on axial CT scans to determine the feasibility of placing a screw in the C-7 lamina, and they evaluated the reliability of the surface of the dorsal arch of C-7 as a landmark for determining the optimal site of screw entry. Methods A total of 207 axial CT scans of C-7 spines were evaluated, and 4 critical measurements were determined for screw entry points, trajectories, and lengths for placement of intralaminar screws. Results The mean width of the right C-7 lamina was 5.9 mm (range 4.2–9.3 mm). The mean width of the left C-7 lamina was 6.0 mm (range 4.2–10.2 mm). The laminar width was too small (< 5.5 mm) in 37.7% of cases to accommodate a 3.5-mm diameter screw, given the desire for at least 1 mm of play on each side of the screw. Conclusions These measurements provide guidelines for operating on the posterior aspect of C-7 and enhance the confidence of the surgeon. Viewing the anatomy of the C-7 laminae in detail through preoperative CT scanning can greatly assist the surgeon in choosing the fixation method. The width of the C-7 lamina is sufficient for intralaminar screw placement in more than 60% of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The screws were inserted manually without radiographic monitoring. [3][4][5] Data are expressed as mean ± SD and range.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Placement of C-7 intralaminar screws: a quantitative anatomical and morphometric evaluation

Şenoğlu¹,

Özkan

Çelık

2012

SPI

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“…Successful treatment of craniocervical fusions, atlantoaxial fixation and axis inclusion in subaxial fixation has been extensively reported in the literature. 11,12 However, if a laminectomy of the axis is necessary for decompressing the spinal cord, obviously C2 laminar screws cannot be used. 1 Additionally, it has the disadvantage of the need to use head screw extension connectors in some cases, since the rods are generally far from the screw head, due to the oblique orientation of the laminar screws compared with subaxial cervical lateral mass screws.…”

Section: C2 Laminar Screw Fixation General Considerationsmentioning

confidence: 99%

Axis Screw Fixation – A Step-by-Step Review of the Surgical Techniques

Joaquim

Riew

2017

Arq Bras Neurocir

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C2 translaminar screw fixation in pediatric occipitocervical fusion

Lee

et al. 2022

Childs Nerv Syst

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Purpose Rigid occipitocervical (O-C) instrumentation can reduce the anterior pathology and has a high fusion rate in children with craniovertebral instability. Typically, axis (C2) screw fixation utilizes C1–C2 transarticular screws or C2 pars screws. However, anatomic variation may preclude these screw types due to the size of fixation elements or by placing the vertebral artery at risk for injury. Pediatric C2 translaminar screw fixation has low risk of vertebral artery injury and may be used when the anatomy is otherwise unsuitable for C1–C2 transarticular screws or C2 pars screws. Methods We retrospectively reviewed a neurosurgical database at UCSF Benioff Children’s Hospital Oakland for patients who had undergone a cervical spinal fusion that utilized translaminar screws for occipitocervical instrumentation between 2002 and 2020. We then reviewed the operative records to determine the parameters of C2 screw fixations performed. Demographic and all other relevant clinical data were then recorded. Results Twenty-five patients ranging from 2 to 18 years of age underwent O-C fusion, with a total of 43 translaminar screws at C2 placed. Twenty-three patients were fused (92%) after initial surgery with a mean follow-up of 43 months. Two patients, both with Down syndrome, had a nonunion. Another 2 patients had a superficial wound dehiscence that required wound revision. One patient died of unknown cause 7 months after surgery. One patient developed an adjacent-level kyphosis. Conclusion When performing occipitocervical instrumentation in the pediatric population, C2 translaminar screw fixation is an effective option to other methods of C2 screw fixation dependent on anatomic feasibility.

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Clinical and radiologic outcome of laminar screw at C2 and C7 for posterior instrumentation—review of 25 cases and comparison of C2 and C7 intralaminar screw fixation

Cited by 38 publications

References 27 publications

Placement of C-7 intralaminar screws: a quantitative anatomical and morphometric evaluation

Placement of C-7 intralaminar screws: a quantitative anatomical and morphometric evaluation

Axis Screw Fixation – A Step-by-Step Review of the Surgical Techniques

C2 translaminar screw fixation in pediatric occipitocervical fusion

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