Journal of Korean Neurosurgical Society

  • 제44권3호
  • /
  • Pages.124-130
  • /
  • 2008
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Comparative Analysis of Cervical Lateral Mass Screw Insertion among Three Techniques in the Korean Population by Quantitative Measurements with Reformatted 2D CT Scan Images : Clinical Research

  • Cho, Jae-Ik (Department of Neurosurgery, Daegu Catholic University School of Medicine) ;
  • Kim, Dae-Hyun (Department of Neurosurgery, Daegu Catholic University School of Medicine)
  • 발행 : 2008.09.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : Our purpose of this study is to compare insertion angles and screw lengths from Roy-Camille, Magerl, and our designed method for cervical lateral mass screw fixation in the Korean population by quantitative measurement of reformatted two dimensional (2D) computed tomography (CT) images. Methods : We selected thirty Korean patients who were evaluated with thin section CT scans and reconstruction program to obtain reformatted 2D-CT images of the transversal plane passing the cranio-caudal angle using three different techniques. We measured the minimum angle to avoid vertebral artery (VA) injury, the ideal angle and depth for bicortical screwing of cervical lateral mass. Morphometric measurements of the lateral masses from C3-C7 were also taken. Results : In all three techniques, the mean safety angles from the VA were less than 8 degrees and the necessary depth of the screw was about 14 mm for safety to the VA and for the bicortical purchase. In our designed technique, the mean $\beta$ angles of each level from C3 to C7 were 29.0. 29.8. 29.5. 26.3. and 23.9 degrees, respectively. Conclusion : Results of this study and data from the literature indicate that differences may exist between the Korean and Western people in the length and angle for ideal lateral mass screw fixation. In addition, our technique needs further cadaveric and clinical study for safety and efficacy for being performed as alternative method for cervical lateral mass fixation.

키워드

참고문헌

  1. An HS, Gordin R, Renner K : Anatomic considerations for platescrew fixation of the cervical spine. Spine 16 (10 Suppl) : S548-551, 1991 https://doi.org/10.1097/00007632-199110001-00019
  2. Anderson PA, Henley MB, Grady MS, Montesano PX, Winn HR : Posterior cervical arthrodesis with AO reconstruction plates and bone graft. Spine 16 (3 Suppl) : S72-79, 1991 https://doi.org/10.1097/00007632-199103001-00012
  3. Barrey C, Mertens P, Jund J, Cotton F, Perrin G : Quantitative anatomic evaluation of cervical lateral mass fixation with a comparison of the Roy-Camille and the Magerl screw techniques. Spine 30 : E140-147, 2005 https://doi.org/10.1097/01.brs.0000155416.35234.a3
  4. Barrey C, Mertens P, Rumelhart C, Cotton F, Jund J, Perrin G : Biomechanical evaluation of cervical lateral mass fixation : a comparison of the Roy-Camille and Magerl screw techniques. J Neurosurg 100 (3 Suppl Spine) : 268-276, 2004
  5. Coe JD, Warden KE, Sutterlin CE 3rd, McAfee PC : Biomechanical evaluation of cervical spinal stabilization methods in a human cadaveric model. Spine 14 : 1122-1131, 1989 https://doi.org/10.1097/00007632-198910000-00016
  6. Coppes MA A : Posterior cervical lateral mass plating. In : Dillin WH, Simeone FA, eds. Posterior Cervical Spine Surgery (Principles and Techniques in Spine Surgery). Chapter 7. Philadelphia : Lippincott-Raven, 1998
  7. Deen HG, Birch BD, Wharen RE, Reimer R : Lateral mass screwrod fixation of the cervical spine : a prospective clinical series with 1- year follow-up. Spine J 3 : 489-495, 2003
  8. Ebraheim NA, An HS, Jackson WT, Brown JA : Internal fixation of the unstable cervical spine using posterior Roy-Camille plates : preliminary report. J Orthop Trauma 3 : 23-28, 1989 https://doi.org/10.1097/00005131-198903010-00005
  9. Ebraheim NA, Hoeflinger MJ, Salpietro B, Chung SY, Jackson WT : Anatomic considerations in posterior plating of the cervical spine. J Orthop Trauma 5 : 196-199, 1991 https://doi.org/10.1097/00005131-199105020-00013
  10. Ebraheim NA, Klausner T, Xu R, Yeasting RA : Safe lateral-mass screw lengths in the Roy-Camille and Magerl techniques. An anatomic study. Spine 23 : 1739-1742, 1998 https://doi.org/10.1097/00007632-199808150-00006
  11. Ebraheim NA, Xu R, Yeasting RA : The location of the vertebral artery foramen and its relation to posterior lateral mass screw fixation. Spine 21 : 1291-1295, 1996 https://doi.org/10.1097/00007632-199606010-00002
  12. Gill K, Paschal S, Corin J, Ashman R, Bucholz RW : Posterior plating of the cervical spine. A biomechanical comparison of different posterior fusion techniques. Spine 13 : 813-816, 1988 https://doi.org/10.1097/00007632-198807000-00018
  13. Harms J, Melcher RP : Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 26 : 2467-2471, 2001 https://doi.org/10.1097/00007632-200111150-00014
  14. Heller JG, Carlson GD, Abitbol JJ, Garfin SR : Anatomic comparison of the Roy-Camille and Magerl techniques for screw placement in the lower cervical spine. Spine 16 : S552-557, 1991 https://doi.org/10.1097/00007632-199110001-00020
  15. Heller JG, Estes BT, Zaouali M, Diop A : Biomechanical study of screws in the lateral masses : variables affecting pull-out resistance. J Bone Joint Surg Am 78 : 1315-1321, 1996 https://doi.org/10.2106/00004623-199609000-00004
  16. Heller JG, Silcox DH 3rd, Sutterlin CE 3rd : Complications of posterior cervical plating. Spine 20 : 2442-2448, 1995 https://doi.org/10.1097/00007632-199511001-00013
  17. Jeanneret B, Magerl F, Ward EH, Ward JC : Posterior stabilization of the cervical spine with hook plates. Spine 16 (3 Suppl) : S56-63, 1991 https://doi.org/10.1097/00007632-199103001-00010
  18. Jonsson H Jr, Rauschning W : Anatomical and morphometric studies in posterior cervical spinal screw-plate systems. J Spinal Disord 7 : 429-438, 1994
  19. Joseffer SS, Post N, Cooper PR, Frempong-Boadu AK : Minimally invasive atlantoaxial fixation with a polyaxial screw-rod construct : technical case report. Neurosurgery 58 (4 Suppl 2) : ONS-E375; discussion ONS-E375, 2006
  20. Katonis P, Papadopoulos CA, Muffoletto A, Papagelopoulos PJ, Hadjipavlou AG : Factors associated with good outcome using lateral mass plate fixation. Orthopedics 27 : 1080-1086, 2004
  21. Kim SH, Shin DA, Yi S, Yoon do H, Kim KN, Shin HC : Early results from posterior cervical fusion with a screw-rod system. Yonsei Med J 48 : 440-448, 2007 https://doi.org/10.3349/ymj.2007.48.3.440
  22. Kotani Y, Cunningham BW, Abumi K, McAfee PC : Biomechanical analysis of cervical stabilization systems. An assessment of transpedicular screw fixation in the cervical spine. Spine 19 : 2529-2539, 1994 https://doi.org/10.1097/00007632-199411001-00007
  23. Nazarian SM, Louis RP : Posterior internal fixation with screw plates in traumatic lesions of the cervical spine. Spine 16 (3 Suppl) : S64-71, 1991 https://doi.org/10.1097/00007632-199103001-00011
  24. Pait TG, McAllister PV, Kaufman HH : Quadrant anatomy of the articular pillars (lateral cervical mass) of the cervical spine. J Neurosurg 82 : 1011-1014, 1995 https://doi.org/10.3171/jns.1995.82.6.1011
  25. Roche S, de Freitas DJ, Lenehan B, Street JT, McCabe JP : Posterior cervical screw placement without image guidance: a safe and reliable practice. J Spinal Disord Tech 19 : 383-388, 2006 https://doi.org/10.1097/00024720-200608000-00001
  26. Roy-Camille R, Saillant G, Mazel C : Internal Fixation of the unstable cervical spine by a posterior osteosynthesis with plates and screws., ed Second edition. Philadelphia : JB Lippincott, 1989
  27. Stulik J, Vyskocil T, Sebesta P, Kryl J : Atlantoaxial fixation using the polyaxial screw-rod system. Eur Spine J 16 : 479-484, 2007 https://doi.org/10.1007/s00586-006-0241-6
  28. Sutterlin CE 3rd, McAfee PC, Warden KE, Rey RM Jr, Farey ID : A biomechanical evaluation of cervical spinal stabilization methods in a bovine model. Static and cyclical loading. Spine 13 : 795-802, 1988 https://doi.org/10.1097/00007632-198807000-00015
  29. Weinstein JN, Spratt KF, Spengler D, Brick C, Reid S : Spinal pedicle fixation : reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement. Spine 13 : 1012-1018, 1988 https://doi.org/10.1097/00007632-198809000-00008
  30. Wellman BJ, Follett KA, Traynelis VC : Complications of posterior articular mass plate fixation of the subaxial cervical spine in 43 consecutive patients. Spine 23 : 193-200, 1998 https://doi.org/10.1097/00007632-199801150-00009
  31. Xu R, Ebraheim NA, Klausner T, Yeasting RA : Modified Magerl technique of lateral mass screw placement in the lower cervical spine : an anatomic study. J Spinal Disord 11 : 237-240, 1998
  32. Xu R, Haman SP, Ebraheim NA, Yeasting RA : The anatomic relation of lateral mass screws to the spinal nerves. A comparison of the Magerl, Anderson, and An techniques. Spine 24 : 2057-2061, 1999 https://doi.org/10.1097/00007632-199910010-00016
  33. Yoon SH, Park HC, Park HS, Kim EY, Ha Y, Chong CK, et al : Radiological considerations of posterior cervical lateral mass fixation using plate and screw. Yonsei Med J 45 : 406-412, 2004 https://doi.org/10.3349/ymj.2004.45.3.406