Fluoroscopic Detection of Ventral Wall Violation during C2 Intralaminar Screw Insertion: A Descriptive Study
Introduction: The C2 (second cervical) laminar screws were considered for rigid fixation of the axis because the use of pars or pedicle screws posed a risk to the vertebral artery with C2. Though considered to be a relatively safe method, ventral spinal canal violations have been reported in lam...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2022-01-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | https://www.ijars.net/articles/PDF/2745/52137_CE[Ra1]_F(SHU)_PF1(AKA_SHU)_PN(SHU).pdf |
| Summary: | Introduction: The C2 (second cervical) laminar screws were
considered for rigid fixation of the axis because the use of pars
or pedicle screws posed a risk to the vertebral artery with C2.
Though considered to be a relatively safe method, ventral spinal
canal violations have been reported in laminar screws fixations.
Fluoroscopy-based image guidance may increase the accuracy
and safety of the technique.
Aim: To report the use of fluoroscopy technique in the detection
of ventral wall violation during C2 intralaminar screw insertion.
Materials and Methods: This descriptive study reports seven
dry axis vertebrae from the adult south Indian population for
which fluoroscopic analysis was done from January 2013 to
December 2013. True lateral views were taken before and after
applying a vertical line of barium paint on the ventral surface of
the lamina at two points: at the centre of the lamina and close
to the facet joints at the face to-laminar junction.
Results: In the total seven dry axis vertebrae analysed, the mean
ratio of the distance from the spinolaminar junction to the barium
line (drawn on the ventral surface of the lamina just next to face
to laminar junction) to the distance between the spinolaminar
junction and uppermost part of inferior articular facet of C2
vertebrae was 0.465±0.0389 mm.
Conclusion: Even though considered a relatively safer technique,
laminar cortical violations have been reported in C2 translaminar
screw fixations. Fluoroscopy-based imaging guidance can improve
the accuracy of C2 translaminar screw insertion, as this technology
provides real-time imaging during the process of screw insertion
and helps in accurate screw sizing. |
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| ISSN: | 2277-8543 2455-6874 |