Safety and efficacy of C2 pedicle screws placed with anatomic and lateral C-arm guidance

Spine
Stephen L OndraTyler Koski

Abstract

This is a retrospective review of 150 C2 pedicle screw placements. Candidates had their C2 pedicle morphology assessed through three-dimensional imaging, including preoperative image guidance. After surgery, the patients were serially CT scanned. Follow-up, with fusion assessment, ranged from 1 to 12 years. We will show that an open technique combined with lateral C-arm guidance provides rapid placement of C2 pedicle screws. C2 pedicle screws can be successful anchors for a variety of cervical problems. Standard intraoperative image guidance, biplane fluoroscopy, or free hand techniques all have their drawbacks. After adequate C2 exposure, the C2 pedicle is palpated. The dissector remains stationary to provide coronal orientation while a lateral C-arm radiograph is obtained for sagittal orientation. The drill trajectory is set, the C2 pedicle cannulated, and a cancellous screw placed. A total of 71 patients had bilateral screws placed and 8 patients had unilateral screws placed. The overall complication rate was 2.7%. In our series, we have found a consistent way to cannulate the C2 pedicle. C2 fixation serves as an integral part of cervical reconstruction. Preoperative planning, anatomic knowledge, and lateral C-arm orientatio...Continue Reading

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Citations

May 11, 2013·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·Janhua WangXiangyang Ma
Oct 4, 2011·Neurosurgical Focus·Melvin D HelgesonK Daniel Riew
Oct 1, 2013·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·Zeng-Hui WuYi-Hong Yin
May 20, 2014·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·Xueshi LiQingshui Yin
Dec 23, 2008·Journal of Pediatric Orthopedics·Daniel Hedequist, Mark Proctor
Apr 2, 2008·Spine·Brian A O'ShaughnessyStephen L Ondra
Feb 27, 2013·Neurologia Medico-chirurgica·Abdullah MarangozAdnan Altun
Apr 10, 2010·Journal of Korean Neurosurgical Society·Hyoung-Joon ChunHyeong-Joong Yi
Jun 22, 2016·World Neurosurgery·Jennifer A Reynolds, Joel D MacDonald
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Dec 31, 2017·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·Shuaishuai XuRuozhen Gong
Jul 22, 2020·Journal of Orthopaedic Surgery and Research·Parisa AzimiAli Montazeri
Aug 12, 2021·Clinical Spine Surgery : a Spine Publication·S Harrison FarberJay D Turner

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