A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory
Study Design Examination using three-dimensional screw trajectory software and computed tomographic scans. Purpose To evaluate the feasibility of a novel trajectory for C7 laminar screws and to compare it with an old trajectory. Overview of Literature The previously reported trajectory of C7 laminar...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2023-08-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2022-0388.pdf |
| _version_ | 1827861472026296320 |
|---|---|
| author | Chee Kean Lee Quan You Li Jiwon Park Sang-Min Park Ho-Joong Kim Bong-Soon Chang Byungjun Woo Jin S. Yeom |
| author_facet | Chee Kean Lee Quan You Li Jiwon Park Sang-Min Park Ho-Joong Kim Bong-Soon Chang Byungjun Woo Jin S. Yeom |
| author_sort | Chee Kean Lee |
| collection | DOAJ |
| description | Study Design Examination using three-dimensional screw trajectory software and computed tomographic scans. Purpose To evaluate the feasibility of a novel trajectory for C7 laminar screws and to compare it with an old trajectory. Overview of Literature The previously reported trajectory of C7 laminar screws has a horizontal direction without a fixed target point. Our new trajectory has a cephalad direction with a fixed target point. Methods Computed tomographic scans of a total of 50 male and 50 female patients were utilized. The placement of C7 laminar screws was activated employing the new and old trajectories. The success rate, the causes of failure, and the maximum allowable length of each trajectory were compared. Results Employing the new trajectory, the success rates of the unilaminar and bilaminar screws were 93% and 83%, respectively, which were significantly better than the old trajectory (80%, p<0.0001 and 70%, p=0.0003). The most prevalent cause of failure was laminar cortical breach followed by facet joint violation. The new trajectory also offered significantly longer maximum allowable screw length in unilaminar (32.5±4.3 mm vs. 26.5±2.6 mm, p<0.001), bilaminar cephalic (29.5±3.8 mm vs. 25.9±2.6 mm, p<0.0001) and bilaminar caudal (33.1±2.6 mm vs. 25.8±3.1 mm, p<0.001) screws than the old trajectory. With the new and old trajectories, 70% vs. 6% of unilaminar, 60% vs. 2% of bilaminar caudal, and 32% vs. 4% of bilaminar cephalic screws could be protracted perfectly into the corresponding lateral mass without any laminar cortical or facet joint violation (p<0.0001). Conclusions The novel trajectory possesses a substantially higher success rate, longer maximum allowable screw length, and higher chance to be extended into the lateral mass (a condition known as a lamino-lateral mass screw) than the old trajectory. |
| first_indexed | 2024-03-12T13:39:20Z |
| format | Article |
| id | doaj.art-5e8bc4bd1b5e492d8b603c3eacf1156a |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-03-12T13:39:20Z |
| publishDate | 2023-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-5e8bc4bd1b5e492d8b603c3eacf1156a2023-08-23T23:49:26ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-08-0117463964610.31616/asj.2022.03881519A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing TrajectoryChee Kean Lee0Quan You Li1Jiwon Park2Sang-Min Park3Ho-Joong Kim4Bong-Soon Chang5Byungjun Woo6Jin S. Yeom7 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan, Korea Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, KoreaStudy Design Examination using three-dimensional screw trajectory software and computed tomographic scans. Purpose To evaluate the feasibility of a novel trajectory for C7 laminar screws and to compare it with an old trajectory. Overview of Literature The previously reported trajectory of C7 laminar screws has a horizontal direction without a fixed target point. Our new trajectory has a cephalad direction with a fixed target point. Methods Computed tomographic scans of a total of 50 male and 50 female patients were utilized. The placement of C7 laminar screws was activated employing the new and old trajectories. The success rate, the causes of failure, and the maximum allowable length of each trajectory were compared. Results Employing the new trajectory, the success rates of the unilaminar and bilaminar screws were 93% and 83%, respectively, which were significantly better than the old trajectory (80%, p<0.0001 and 70%, p=0.0003). The most prevalent cause of failure was laminar cortical breach followed by facet joint violation. The new trajectory also offered significantly longer maximum allowable screw length in unilaminar (32.5±4.3 mm vs. 26.5±2.6 mm, p<0.001), bilaminar cephalic (29.5±3.8 mm vs. 25.9±2.6 mm, p<0.0001) and bilaminar caudal (33.1±2.6 mm vs. 25.8±3.1 mm, p<0.001) screws than the old trajectory. With the new and old trajectories, 70% vs. 6% of unilaminar, 60% vs. 2% of bilaminar caudal, and 32% vs. 4% of bilaminar cephalic screws could be protracted perfectly into the corresponding lateral mass without any laminar cortical or facet joint violation (p<0.0001). Conclusions The novel trajectory possesses a substantially higher success rate, longer maximum allowable screw length, and higher chance to be extended into the lateral mass (a condition known as a lamino-lateral mass screw) than the old trajectory.http://www.asianspinejournal.org/upload/pdf/asj-2022-0388.pdfcervical vertebraec7screw trajectorylaminar screwlamino-lateral mass screw |
| spellingShingle | Chee Kean Lee Quan You Li Jiwon Park Sang-Min Park Ho-Joong Kim Bong-Soon Chang Byungjun Woo Jin S. Yeom A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory Asian Spine Journal cervical vertebrae c7 screw trajectory laminar screw lamino-lateral mass screw |
| title | A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory |
| title_full | A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory |
| title_fullStr | A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory |
| title_full_unstemmed | A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory |
| title_short | A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory |
| title_sort | novel trajectory of c7 laminar screws determined using three dimensional computed tomography and surgical simulation software comparison with a pre existing trajectory |
| topic | cervical vertebrae c7 screw trajectory laminar screw lamino-lateral mass screw |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2022-0388.pdf |
| work_keys_str_mv | AT cheekeanlee anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT quanyouli anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT jiwonpark anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT sangminpark anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT hojoongkim anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT bongsoonchang anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT byungjunwoo anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT jinsyeom anoveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT cheekeanlee noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT quanyouli noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT jiwonpark noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT sangminpark noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT hojoongkim noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT bongsoonchang noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT byungjunwoo noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory AT jinsyeom noveltrajectoryofc7laminarscrewsdeterminedusingthreedimensionalcomputedtomographyandsurgicalsimulationsoftwarecomparisonwithapreexistingtrajectory |