Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Anatomic Consideration of the C1 Laminar Arch for Lateral Mass Screw Fixation via C1 Lateral Lamina : A Landmark between the Lateral and Posterior Lamina of the C1

  • Kim, Jung-Hwan (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kwak, Dai-Soon (Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea) ;
  • Han, Seung-Ho (Department of Anatomy, College of Medicine, Chung-Ang University) ;
  • Cho, Sung-Min (Department of Neurosurgery, Donghae Dong-In Hospital) ;
  • You, Seung-Hoon (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Moon-Kyu (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • Received : 2012.12.22
  • Accepted : 2013.07.17
  • Published : 2013.07.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : To clarify the landmark for deciding the entry point for C1 lateral mass screws via the posterior arch by using 3-dimensional (3D) computed images. Methods : Resnick insisted that the C1 posterior arch could be divided into pure posterior and lateral lamina (C1 pedicle). Authors studied where this transition point (TP) is located between the posterior lamina and the C1 pedicle and how it can be recognized. The 3D computed images of 86 cadaver C1s (M : F=45 : 41) were used in this study. Results : The superior ridge of the C1 posterior arch had 2 types of orientation. One was in the vertical direction in the C1 posterior lamina and the other was in the horizontal direction in the C1 pedicle. The TP was located at the border between the 2 areas, the same site as the posterior end of the groove of the vertebral artery. On posterior-anterior projection, the posterior arch was sharpened abruptly at TP. We were unable to identify the TP in 6.4% of specimens due to complete or partial osseous bridges. A total of 93.8% of the TP were located between the most enlarged point of the spinal canal and the medial wall of the vertebral artery. Conclusion : The anatomic entry zone of C1 lateral laminar screws was clarified and identified based on the TP by using preoperative 3D computed images.

Keywords

References

  1. Christensen DM, Eastlack RK, Lynch JJ, Yaszemski MJ, Currier BL : C1 anatomy and dimensions relative to lateral mass screw placement. Spine (Phila Pa 1976) 32 : 844-848, 2007 https://doi.org/10.1097/01.brs.0000259833.02179.c0
  2. Chun HJ, Bak KH : Targeting a safe entry point for c2 pedicle screw fixation in patients with atlantoaxial instability. J Korean Neurosurg Soc 49 : 351-354, 2011 https://doi.org/10.3340/jkns.2011.49.6.351
  3. Gebauer M, Barvencik F, Briem D, Kolb JP, Seitz S, Rueger JM, et al. : Evaluation of anatomic landmarks and safe zones for screw placement in the atlas via the posterior arch. Eur Spine J 19 : 85-90, 2010 https://doi.org/10.1007/s00586-009-1181-8
  4. Goel A, Kulkarni AG : Re : Tan M, Wang H, Wang Y, et al. : Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass. Spine. 2003;28:888-95. Spine (Phila Pa 1976) 29 : 1706; author reply 1706, 2004 https://doi.org/10.1097/01.BRS.0000132303.72204.C2
  5. Goel A, Laheri V : Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 129 : 47-53, 1994 https://doi.org/10.1007/BF01400872
  6. Harms J, Melcher RP : Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976) 26 : 2467-2471, 2001 https://doi.org/10.1097/00007632-200111150-00014
  7. Karau PB, Ogengo JA, Hassanali J, Odula P : Anatomy and prevalence of atlas vertebrae bridges in a Kenyan population : an osteological study. Clin Anat 23 : 649-653, 2010 https://doi.org/10.1002/ca.21010
  8. Kobayashi Y, Kikuchi S, Konno S, Sekiguchi M : Insertion of lateral mass screw of the atlas via the posterior arch : anatomical study of screw insertion using dry bone samples of the atlas from Japanese cadavers. J Orthop Sci 13 : 452-455, 2008 https://doi.org/10.1007/s00776-008-1255-1
  9. Lamberty BG, Zivanovic S : The retro-articular vertebral artery ring of the atlas and its significance. Acta Anat (Basel) 85 : 113-122, 1973 https://doi.org/10.1159/000143987
  10. Lee MJ, Cassinelli E, Riew KD : The feasibility of inserting atlas lateral mass screws via the posterior arch. Spine (Phila Pa 1976) 31 : 2798-2801, 2006 https://doi.org/10.1097/01.brs.0000245902.93084.12
  11. Ma XY, Yin QS, Wu ZH, Xia H, Liu JF, Xiang M, et al. : C1 pedicle screws versus C1 lateral mass screws : comparisons of pullout strengths and biomechanical stabilities. Spine (Phila Pa 1976) 34 : 371-377, 2009 https://doi.org/10.1097/BRS.0b013e318193a21b
  12. Ma XY, Yin QS, Wu ZH, Xia H, Liu JF, Zhong SZ : Anatomic considerations for the pedicle screw placement in the first cervical vertebra. Spine (Phila Pa 1976) 30 : 1519-1523, 2005 https://doi.org/10.1097/01.brs.0000168546.17788.49
  13. Ma XY, Yin QS, Wu ZH, Xia H, Zhong SZ, Liu JF, et al. : [Anatomic identification of the location of the pedicle of atlas with the lateral mass of C2 to C4 as the landmark]. Zhonghua Wai Ke Za Zhi 43 : 774-776, 2005
  14. Murakami S, Mizutani J, Fukuoka M, Kato K, Sekiya I, Okamoto H, et al. : Relationship between screw trajectory of C1 lateral mass screw and internal carotid artery. Spine (Phila Pa 1976) 33 : 2581-2585, 2008 https://doi.org/10.1097/BRS.0b013e318186b2fd
  15. Pan J, Li L, Qian L, Tan J, Sun G, Li X : C1 lateral mass screw insertion with protection of C1-C2 venous sinus : technical note and review of the literature. Spine (Phila Pa 1976) 35 : E1133-E1136, 2010 https://doi.org/10.1097/BRS.0b013e3181e215ff
  16. Resnick DK, Benzel EC : C1-C2 pedicle screw fixation with rigid cantilever beam construct : case report and technical note. Neurosurgery 50 : 426-428, 2002
  17. Resnick DK, Lapsiwala S, Trost GR : Anatomic suitability of the C1-C2 complex for pedicle screw fixation. Spine (Phila Pa 1976) 27 : 1494-1498, 2002 https://doi.org/10.1097/00007632-200207150-00003
  18. Rhee WT, You SH, Kim SK, Lee SY : Troublesome occipital neuralgia developed by c1-c2 harms construct. J Korean Neurosurg Soc 43 : 111-113, 2008 https://doi.org/10.3340/jkns.2008.43.2.111
  19. Rocha R, Safavi-Abbasi S, Reis C, Theodore N, Bambakidis N, de Oliveira E, et al : Working area, safety zones, and angles of approach for posterior C-1 lateral mass screw placement : a quantitative anatomical and morphometric evaluation. J Neurosurg Spine 6 : 247-254, 2007 https://doi.org/10.3171/spi.2007.6.3.247
  20. Simsek S, Yigitkanli K, Comert A, Acar HI, Seckin H, Er U, et al. : Posterior osseous bridging of C1. J Clin Neurosci 15 : 686-688, 2008 https://doi.org/10.1016/j.jocn.2007.06.004
  21. Tan M, Wang H, Wang Y, Zhang G, Yi P, Li Z, et al. : Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass. Spine (Phila Pa 1976) 28 : 888-895, 2003
  22. Williams PL, Warwick R, Dyson M, Bannister LH : Gray's Anatomy, ed 37. New York : Churchill Livingstone, Inc, 1989, pp494

Cited by

  1. Is the 4 mm height of the vertebral artery groove really a limitation of C1 pedicle screw insertion? vol.23, pp.5, 2013, https://doi.org/10.1007/s00586-014-3217-y
  2. The Clinical Experience of Computed Tomographic-Guided Navigation System in C1-2 Spine Instrumentation Surgery vol.56, pp.4, 2013, https://doi.org/10.3340/jkns.2014.56.4.330
  3. Applied anatomy of screw placement via the posterior arch of the atlas and anatomy-based refinements of the technique vol.26, pp.7, 2013, https://doi.org/10.1007/s00590-016-1771-1
  4. Computed Tomographic Morphometric Analysis of C1 and C2 for Lamina Cross Screw Placement in Malay Ethnicity vol.15, pp.1, 2013, https://doi.org/10.31616/asj.2019.0242