Safe zone for C1 lateral mass screws: anatomic and radiological study

Neurosurgery
Serkan SimsekAlaittin Elhan

Abstract

To evaluate the possible complications of overpenetrated C1 lateral mass screws and to identify and define a "safe zone" area anterior to the C1 vertebra. The study was performed on 10 cadavers and 50 random patients who had undergone computed tomographic scanning with contrast medium of the neck for other purposes. Atlas lateral mass screw trajectories were plotted, and the safe zone for screw placement anterior to the atlas vertebra was determined for each trajectory. The trajectory of the internal carotid artery was measured from its medial wall. The trajectory of the internal carotid artery according to the ideal entrance point of the screw was 11.55 +/- 4.55 degrees (range, 2-22 degrees) in the cadavers and 9.78 +/- 4.55 degrees (range, -5 to 22 degrees) bilaterally in the patients. At 15 degrees (ideal screw trajectory), the thickness of the rectus capitis anterior muscle and longus capitis muscle was 6.69 +/- 0.83 mm (range, 5.32-7.92 mm) in the cadavers and 7.29 +/- 1.90 mm (range, 0.50-13.63 mm) bilaterally in the patients. The smallest distance from the internal carotid artery to the anterior cortex of the C1 vertebra was calculated as 4.33 +/- 2.03 mm (range, 1.15-8.40 mm) bilaterally in the cadavers and 5.07 +/- 1.7...Continue Reading

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Citations

Jan 20, 2012·Clinical Neurology and Neurosurgery·Feng-Zeng JianFeng Ling
Jul 10, 2012·British Journal of Neurosurgery·Wilson Z RayTodd Stewart
Dec 28, 2017·Surgical and Radiologic Anatomy : SRA·Sibel CirpanSait Naderi
Mar 12, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yue-Qi DuXin-Guang Yu
Apr 29, 2021·British Journal of Neurosurgery·Kazim YigitkanliAslan Guzel
Dec 21, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Selda Aksoy, Bulent Yalcin

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