New entry point for C2 screw, in posterior C1-C2 fixation (Goel-Harm’s technique) significantly reducing the possibility of vertebral artery injury

Patkar, Sushil

doi:10.1080/01616412.2015.1105582

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…Facet fixation of the atlas and axis has become the standard of care. Intraoperative bleeding and vertebral artery injury remain the main issues in terms of complications, although techniques including neuronavigation and preoperative 3-dimensional model prints have been proposed to decrease the surgical morbidity [5-7].…”

Section: Discussionmentioning

confidence: 99%

Anterior Retropharyngeal Cage Distraction and Fixation for Basilar Invagination: “The Wedge Technique”

Patkar

2019

Neurospine

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Objective: Surgery is indicated for basilar invagination (BI) in symptomatic patients. In many patients, symptoms and signs occur due to an upward-migrated and malaligned odontoid with fixed or mobile atlantoaxial instability. Posterior distraction and fixation of the atlantoaxial joints has evolved to become the standard of care, but has some inherent morbidity. In this study, we propose that the unilateral anterior submandibular retropharyngeal approach with customized wedge-shaped titanium cages inserted into both atlantoaxial joints and anterior atlantoaxial fixation with a plate screw construct is a safer and easier option in many cases of BI. Methods: From February 2014 to February 2019, 52 patients (age range, 15-78 years; 40 males and 12 females) with symptomatic BI with atlantoaxial dislocation and minimal sagittal facetal inclination and only mild Chiari malformation without syringomyelia were offered anterior submandibular retropharyngeal atlantoaxial distraction and fixation surgery. Results: Neurological improvement occurred in 80% of patients, while the neurological status of 20% remained unchanged. No patients worsened, and no major complications or mortality was observed. Conclusion: In properly selected cases of symptomatic BI, anterior wedge cage distraction with anterior atlantoaxial fixation is a safe and simple option.

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Section: Discussionmentioning

confidence: 99%

Anterior Retropharyngeal Cage Distraction and Fixation for Basilar Invagination: “The Wedge Technique”

Patkar

2019

Neurospine

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“…The final results were displayed in an intuitive graph. This results might reveal the abnormal anatomy and pathology of AAJ dislocation and VA lumen stenosis, and provide a tool and platform for studying on the diagnosis and treatment of related to AAJ and VA diseases [8,9,10].…”

Section: Discussionmentioning

confidence: 99%

Finite Element Modeling of Atlantoaxial Joint with the Vertebral Artery Based on CT Data

Duan¹,

Zhang²,

Lin³

et al. 2016

Proceedings of the 2016 4th International Conference on Management, Education, Information and Control (MEICI 2016)

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Abstract. Based on the data of atlantoaxial joint (AAJ) by contrast-enhanced CT scan, finite element modeling (FEM) of AAJ with vertebral artery (VA) was constituted and its feasibility and possible application were evaluated. CT data of AAJ with VA was selected from PACS in our hospital. The occipital, vertebral body and VA were distinguished and saved them as the STL format, the geometric and finite element model of AAJ with VA were established with adjusting the relevant parameters. Comparison was made between the model and 3D-image, and AAJ functions were simulated. FEM cannot clearly only show or measure the morphology of AAJ and VA, but observe the AAJ rotary motion and have a force analysis. In conclusion, FEM of AAJ with VA is a practical method on the CT data, and it has a high reliability, and can be used for studying the anatomy and biomechanics of AAJ.

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“…Although the vertebral artery is located medial to the SPC, the SPC screw with a larger cephalad angle can avoid the vertebral artery. 27 In addition, screw placement simulation before the operation can ensure the safety of the SPC.…”

Section: Advantages Of the Spc Screwmentioning

confidence: 99%

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

Deng

Zeng

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Study Design: A 3D-CT Study. Objective: To research the feasibility and advantages of screw corridors parallel to the sagittal plane (SPC) of the C2 for transpedicular fixation. Summary of Background Data: A total of 125 patients were enrolled for analysis, and the 3D model of the C2 for the 125 patients were reconstructed and analyzed. Methods: The SPC screw and the corridor of the general pedicle (GPC) screw of both sides were inserted into these C2 models. The anatomic parameters of the SPC and GPC, including the inner circle diameter, length of the corridors, medial angle and cephalad angle, were measured and compared. The anatomic location of the entry point for the SPC screw was evaluated. Results: The diameter of the SPC averaged 5.5±1.8 mm; 81.2% (203/250) were larger than 4 mm. There was no significant difference between the SPC and GPC in diameter or percentage of diameter greater than 4 mm. There was a significant difference between the length of the SPC (25.3±2.4 mm) and the GPC (27.4±2.2 mm). The cephalad angle was 51.6±6.9° for the SPC and 43.3±4.4° for the GPC, and there was a significant difference between the SPC and GPC. The entry point of the SPC screw was located on the cortical crest at the lower 1/4 of the lamina and located to the lower and inner side of the GPC screw entry point. Conclusion: It is feasible for most patients to accommodate an SPC screw with a diameter of 3.5 mm. All SPC screws crossed the pedicle completely. The optimal entry point of the SPC screw was located on the cortical crest of the axial lamina.

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New entry point for C2 screw, in posterior C1-C2 fixation (Goel-Harm’s technique) significantly reducing the possibility of vertebral artery injury

Abstract: The new technique of C2 screw fixation allows rigid immobilization of the C1-C2 joint without significant risk of vertebral artery injury.

Cited by 14 publications

References 19 publications

Anterior Retropharyngeal Cage Distraction and Fixation for Basilar Invagination: “The Wedge Technique”

Anterior Retropharyngeal Cage Distraction and Fixation for Basilar Invagination: “The Wedge Technique”

Finite Element Modeling of Atlantoaxial Joint with the Vertebral Artery Based on CT Data

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

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