Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images
In C1–C2 posterior fixation, the C1 lateral mass and C2 pedicle/translaminar screw insertion under spine navigation have been used frequently. To avoid the risk of neurovascular damage in atlantoaxial stabilization, we assessed the safety and effectiveness of a preoperative computed tomography (CT)...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2023-06-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://asianspinejournal.org/upload/pdf/asj-2022-0182.pdf |
| _version_ | 1797795312834707456 |
|---|---|
| author | Yasunobu Itoh Ryo Kitagawa Shinichi Numazawa Kota Yamakawa Osamu Yamada Isao Akasu Jun Sakai Tomoko Otomo Hirotaka Yoshida Kentaro Mori Sadayoshi Watanabe Kazuo Watanabe |
| author_facet | Yasunobu Itoh Ryo Kitagawa Shinichi Numazawa Kota Yamakawa Osamu Yamada Isao Akasu Jun Sakai Tomoko Otomo Hirotaka Yoshida Kentaro Mori Sadayoshi Watanabe Kazuo Watanabe |
| author_sort | Yasunobu Itoh |
| collection | DOAJ |
| description | In C1–C2 posterior fixation, the C1 lateral mass and C2 pedicle/translaminar screw insertion under spine navigation have been used frequently. To avoid the risk of neurovascular damage in atlantoaxial stabilization, we assessed the safety and effectiveness of a preoperative computed tomography (CT) image-based navigation system with intraoperative independent C1 and C2 vertebral registration. It is ideal when a reference frame can be linked directly to the C1 posterior arch for C1-direct-captured navigation, but there is a mechanical challenge. A new spine clamp-tracker system was implemented recently, which allows reliable C1- and C2-direct-captured navigation in nine patients with traumatic C2 fractures. In this way, there was no misalignment of C1–C2 screws. C1 lateral mass screws were used except for one case, and translaminar screws were primarily used as an anchor for C2. The C1 lateral mass screw locations, which are 19 mm laterally from the C1 posterior arch’s center, are taken to be constant. However, there is one unusual circumstance in which using a C1 laminar hook instead of a C1 lateral mass screw appears to be a beneficial substitute. The increase of surgical accuracy for posterior C1–C2 screw fixation without cost constraints is significantly facilitated by intraoperative C1- and C2-direct-captured navigation with preoperative computed CT images. |
| first_indexed | 2024-03-13T03:16:00Z |
| format | Article |
| id | doaj.art-5f106aa2a58b472388fecbb74fcdecb5 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-03-13T03:16:00Z |
| publishDate | 2023-06-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-5f106aa2a58b472388fecbb74fcdecb52023-06-26T01:29:49ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-06-0117355956610.31616/asj.2022.01821517Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography ImagesYasunobu Itoh0Ryo Kitagawa1Shinichi Numazawa2Kota Yamakawa3Osamu Yamada4Isao Akasu5Jun Sakai6Tomoko Otomo7Hirotaka Yoshida8Kentaro Mori9Sadayoshi Watanabe10Kazuo Watanabe11 Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan Department of Neurosurgery, Southern Tohoku General Hospital, Koriyama, JapanIn C1–C2 posterior fixation, the C1 lateral mass and C2 pedicle/translaminar screw insertion under spine navigation have been used frequently. To avoid the risk of neurovascular damage in atlantoaxial stabilization, we assessed the safety and effectiveness of a preoperative computed tomography (CT) image-based navigation system with intraoperative independent C1 and C2 vertebral registration. It is ideal when a reference frame can be linked directly to the C1 posterior arch for C1-direct-captured navigation, but there is a mechanical challenge. A new spine clamp-tracker system was implemented recently, which allows reliable C1- and C2-direct-captured navigation in nine patients with traumatic C2 fractures. In this way, there was no misalignment of C1–C2 screws. C1 lateral mass screws were used except for one case, and translaminar screws were primarily used as an anchor for C2. The C1 lateral mass screw locations, which are 19 mm laterally from the C1 posterior arch’s center, are taken to be constant. However, there is one unusual circumstance in which using a C1 laminar hook instead of a C1 lateral mass screw appears to be a beneficial substitute. The increase of surgical accuracy for posterior C1–C2 screw fixation without cost constraints is significantly facilitated by intraoperative C1- and C2-direct-captured navigation with preoperative computed CT images.http://asianspinejournal.org/upload/pdf/asj-2022-0182.pdfc1 lateral mass screwc2 translaminar screwspine clampspine navigationiliac bone graft |
| spellingShingle | Yasunobu Itoh Ryo Kitagawa Shinichi Numazawa Kota Yamakawa Osamu Yamada Isao Akasu Jun Sakai Tomoko Otomo Hirotaka Yoshida Kentaro Mori Sadayoshi Watanabe Kazuo Watanabe Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images Asian Spine Journal c1 lateral mass screw c2 translaminar screw spine clamp spine navigation iliac bone graft |
| title | Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images |
| title_full | Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images |
| title_fullStr | Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images |
| title_full_unstemmed | Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images |
| title_short | Atlantoaxial Stabilization Using C1 Lateral Mass and C2 Pedicle/Translaminar Screw Fixation by Intraoperative C1- and C2-Direct-Captured Navigation with Preoperative Computed Tomography Images |
| title_sort | atlantoaxial stabilization using c1 lateral mass and c2 pedicle translaminar screw fixation by intraoperative c1 and c2 direct captured navigation with preoperative computed tomography images |
| topic | c1 lateral mass screw c2 translaminar screw spine clamp spine navigation iliac bone graft |
| url | http://asianspinejournal.org/upload/pdf/asj-2022-0182.pdf |
| work_keys_str_mv | AT yasunobuitoh atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT ryokitagawa atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT shinichinumazawa atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT kotayamakawa atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT osamuyamada atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT isaoakasu atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT junsakai atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT tomokootomo atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT hirotakayoshida atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT kentaromori atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT sadayoshiwatanabe atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages AT kazuowatanabe atlantoaxialstabilizationusingc1lateralmassandc2pedicletranslaminarscrewfixationbyintraoperativec1andc2directcapturednavigationwithpreoperativecomputedtomographyimages |