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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 214 - 223 (10page)
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초록· 키워드
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Study Design: Computed tomographic (CT) morphometric analysis. Purpose: To assess the feasibility and safety of occipital condyle (OC)-based occipitocervical fixation (OCF) in Indians and to define anatomical zones and screw lengths for safe screw placement. Overview of Literature: Limitations of occipital squama-based OCF has led to development of two novel OC-based OCF techniques. Methods: Morphometric analysis was performed on the OCs of 70 Indian adults. The feasibility of placing a 3.5-mm-diameter screw into OCs was investigated. Safe trajectories and screw lengths for OC screws and C0–C1 transarticular screws without hypoglossal canal or atlantooccipital joint compromise were estimated. Results: The average screw length and safe sagittal and medial angulations for OC screws were 19.9±2.3 mm, ≤6.4°±2.4° cranially, and 31.1°±3° medially, respectively. An OC screw could not be accommodated by 27% of the population. The safe sagittal angles and screw lengths for C0–C1 transarticular screw insertion (48.9°±5.7° cranial, 26.7±2.9 mm for junctional entry technique; 36.7°±4.6° cranial, 31.6±2.7 mm for caudal C1 arch entry technique, respectively) were significantly different than those in other populations. The risk of vertebral artery injury was high for the caudal C1 arch entry technique. Screw placement was uncertain in 48% of Indians due to the presence of aberrant anatomy. Conclusions: There were significant differences in the metrics of OC-based OCF between Indian and other populations. Because of the smaller occipital squama dimensions in Indians, OC-based OCF techniques may have a higher application rate and could be a viable alternative/salvage option in selected cases. Preoperative CT, including three-dimensional-CT-angiography (to delineate vertebral artery course), is imperative to avoid complications resulting from aberrant bony and vascular anatomy. Our data can serve as a valuable reference guide in placing these screws safely under fluoroscopic guidance.
목차
등록된 정보가 없습니다.
참고문헌 (34)
참고문헌 신청
Stock GH / 2006 / Contemporary posterior occipital fixation / J Bone Joint Surg Am 88:1642~1649
Winegar CD / 2010 / A systematic review of occipital cervical fusion: techniques and outcomes / J Neurosurg Spine 13:5~16
Smucker JD / 2006 / The evolution of spinal instrumentation for the management of occipital cervical and cervicothoracic junctional injuries / Spine (Phila Pa 1976) 31(11 Suppl):S44~S52
Vender JR / 2004 / The evolution of posterior cervical and occipitocervical fusion and instrumentation / Neurosurg Focus 16:E9
Hwang SW / 2012 / Complications of occipital screw placement for occipitocervical fusion in children / J Neurosurg Pediatr 9:586~593
Winegar CD / 2010 / A systematic review of occipital cervical fusion: techniques and outcomes / J Neurosurg Spine 13:5~16
Smucker JD / 2006 / The evolution of spinal instrumentation for the management of occipital cervical and cervicothoracic junctional injuries / Spine (Phila Pa 1976) 31(11 Suppl):S44~S52
Vender JR / 2004 / The evolution of posterior cervical and occipitocervical fusion and instrumentation / Neurosurg Focus 16:E9
Hwang SW / 2012 / Complications of occipital screw placement for occipitocervical fusion in children / J Neurosurg Pediatr 9:586~593
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