The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population

Abstract Background To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. Methods One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. Results The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. Conclusion A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique.

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Main Authors: Vázquez-García,B, Villas,C, Pueyo,J, Broncano,J, Donat-Vargas,CL, Alfonso,M
Format: Digital revista
Language:English
Published: Gobierno de Navarra. Departamento de Salud 2020
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272020000300004
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spelling oai:scielo:S1137-662720200003000042021-06-17The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish populationVázquez-García,BVillas,CPueyo,JBroncano,JDonat-Vargas,CLAlfonso,M C2 lamina C2 spinous processes Atlantoaxial fixation C2 translaminar screw Multi-detector CT scan Abstract Background To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. Methods One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. Results The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. Conclusion A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique.Gobierno de Navarra. Departamento de SaludAnales del Sistema Sanitario de Navarra v.43 n.3 20202020-12-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272020000300004en
institution SCIELO
collection OJS
country España
countrycode ES
component Revista
access En linea
databasecode rev-scielo-es
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Vázquez-García,B
Villas,C
Pueyo,J
Broncano,J
Donat-Vargas,CL
Alfonso,M
spellingShingle Vázquez-García,B
Villas,C
Pueyo,J
Broncano,J
Donat-Vargas,CL
Alfonso,M
The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
author_facet Vázquez-García,B
Villas,C
Pueyo,J
Broncano,J
Donat-Vargas,CL
Alfonso,M
author_sort Vázquez-García,B
title The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
title_short The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
title_full The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
title_fullStr The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
title_full_unstemmed The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population
title_sort dimensions of the posterior arch of c2 for instrumented screw fixation. a radiological study in the spanish population
description Abstract Background To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. Methods One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. Results The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. Conclusion A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique.
publisher Gobierno de Navarra. Departamento de Salud
publishDate 2020
url http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272020000300004
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