Anatomy of Lamina in the Subaxial Cervical Spine With the Special Reference to Translaminar Screws: CT and Cadaveric Analysis With Screw Trajectory Simulation

Clinical Spine Surgery : a Spine Publication
Woojin ChoFrancis H Shen

Abstract

A cadaveric study. Translaminar screws were initially developed for C2 fixation. Since then, their usage has expanded to include the subaxial cervical spine, and thoracic and lumbar spine. To the best of our knowledge, special anatomy for inserting translaminar screws in the subaxial cervical spine has not been studied. To report the special anatomy for inserting translaminar screws in the subaxial cervical spine. A total of 18 cadaveric spines were harvested from C3 to C7 and 1 mm computed tomography (CT) scans and 3D reconstructions were obtained. Bilateral translaminar screw entry points and trajectories were simulated at each level from C3 to C7 utilizing Kodak Carestream/Pacs Ver 10.2. Constructs were selected to achieve maximal bony purchase with 1 screw, designated the "primary screw." The contralateral screw, designated the "secondary screw," was selected to achieve the optimal allowable diameter possible while avoiding a simulated cortical breach, which was not always necessarily the "best purchase" diameter. Initial screw diameters selected were 3.5 mm; however, in the event that a narrower portion was encountered, then a 3.0 mm diameter screw was utilized instead. The crossing area of both screws were calculated geom...Continue Reading

References

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