Turkish Neurosurgery
Morphometric characteristics C1-C2 vertebrae to perform anterior transarticular crossing screw fixation
Kagan Tun1, Berker Cemil2, Emre Cemal Gokce3
1Acibadem University, Eskisehir Acibadem Hospital, Neurosurgery Department, Eskisehir,
2Private Practice Specialists, Neurosurgeon, Ankara,
3Ministry of Health Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Neurosurgery Department, Ankara,
DOI: 10.5137/1019-5149.JTN.18971-16.1

Aim:In unique clinical situations where C1-C2 posterior fixation is not available or has previously failed, an anterior transarticular screw (ATAS) may be a viable alternative. However, there aren’t previous reports that investigate possible screw angles, screw entry points, and screw length based on computerized tomography multiplanar reconstruction images in Turkish patients. To determine the morphometric characteristics C1-C2 vertebrae to perform anterior transarticular crossing screw fixation.Material and Methods:Patients who underwent a complete CT scan of the cervical spine for causes other than an investigation of cervical spine malformation or congenital anomaly between the years 2013 and 2015 were included in this study. The anterior transarticular C1-C2 screw angles, screw entry point, and screw length were measured on coronal and sagittal computerized tomography multiplanar reconstruction images. Results:Twenty-five male and 14 female patients were included in the study. The mean maximum screw angle for ATAS was found to be 41.18o±4.49o. The minimum and maximum screw lengths were measured at 27.46±3.39 mm and 28.46±3.60 mm, respectively. Conclusion:Preoperatively, performing a calculation of the possible screw angles, screw entry point, and screw length according based on computerized tomography multiplanar reconstruction images for ATAS is a safe and applicable method. In cases in which ATAS fixation across the atlantoaxial joint procedure should be performed without performing a measurement, a screw angle not more than 41.18 ° ± 4.49 ° on the coronal plane does not damage the vertebral artery; furthermore, using screws shorter than 28.46±3.60mm doesn’t purchase the atlantoaxial joint.

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