Application of laminar screws to posterior fusion of cervical spine

Measurement of the cervical vertebral arch diameter with a navigation system

Kazuo Nakanishi, Masato Tanaka, Yoshihisa Sugimoto, Haruo Misawa, Tomoyuki Takigawa, Kazuo Fujiwara, Keiichiro Nishida, Toshihumi Ozaki

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

STUDY DESIGN. Morphometric analysis. OBJECTIVE. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used. SUMMARY OF BACKGROUND DATA. Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion. In 2004, a new method to avoid such vertebral artery injuries was reported by insertion of screws with crosswise to the lamina of C2. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used. There is no report of the diameter of the vertebral arch by a navigation system. METHODS. Morphometric analysis was performed on 42 patients who had undergone a CT scan of the cervical spine for either surgery or diagnostic purposes. To examine the possibilities to insert laminar screws, the diameter of the vertebral arch was measured using a navigation system. RESULTS. The diameter of the vertebral arch in C2 was the largest in the cervical spine, individual differences ranging between 0.8 and 8.4 mm. In C2, insertion of screws with a diameter of 3 mm was possible in 80% of males and 63% of females. As for screws with a diameter of 4 mm, insertion was possible in 50% of the males and 24% of the females in C2. In C2, gender had a significant effect, but left-right differences and height did not. CONCLUSION. Laminar screws are useful as they can prevent vascular injuries, but a preoperative evaluation is necessary.

Original languageEnglish
Pages (from-to)620-623
Number of pages4
JournalSpine
Volume33
Issue number6
DOIs
Publication statusPublished - Mar 2008

Fingerprint

Spine
Vertebral Artery
Vascular System Injuries
Individuality
Wounds and Injuries
Pedicle Screws

Keywords

  • Laminar screw
  • Lateral mass screw
  • Neurovascular complications
  • Pedicle screw
  • Transarticular screw

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Application of laminar screws to posterior fusion of cervical spine : Measurement of the cervical vertebral arch diameter with a navigation system. / Nakanishi, Kazuo; Tanaka, Masato; Sugimoto, Yoshihisa; Misawa, Haruo; Takigawa, Tomoyuki; Fujiwara, Kazuo; Nishida, Keiichiro; Ozaki, Toshihumi.

In: Spine, Vol. 33, No. 6, 03.2008, p. 620-623.

Research output: Contribution to journalArticle

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abstract = "STUDY DESIGN. Morphometric analysis. OBJECTIVE. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used. SUMMARY OF BACKGROUND DATA. Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion. In 2004, a new method to avoid such vertebral artery injuries was reported by insertion of screws with crosswise to the lamina of C2. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used. There is no report of the diameter of the vertebral arch by a navigation system. METHODS. Morphometric analysis was performed on 42 patients who had undergone a CT scan of the cervical spine for either surgery or diagnostic purposes. To examine the possibilities to insert laminar screws, the diameter of the vertebral arch was measured using a navigation system. RESULTS. The diameter of the vertebral arch in C2 was the largest in the cervical spine, individual differences ranging between 0.8 and 8.4 mm. In C2, insertion of screws with a diameter of 3 mm was possible in 80{\%} of males and 63{\%} of females. As for screws with a diameter of 4 mm, insertion was possible in 50{\%} of the males and 24{\%} of the females in C2. In C2, gender had a significant effect, but left-right differences and height did not. CONCLUSION. Laminar screws are useful as they can prevent vascular injuries, but a preoperative evaluation is necessary.",
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