Abstract:
OBJECTIVE:Knowledge of the course of the vertebral artery during instrumentation is of paramount importance. It has been shown that erosion of the C2 pedicle and body can occur due to pulsations of the adjacent vertebral artery. This often results in a "cave" for this segment of the artery. The descriptions of this anatomy are limited. The current study was performed with the hope that these data will be of use to spine surgeons during C2 instrumentation. METHODS:In 40 human adult C2 bone specimens, the position of the vertebral artery in relation to the undersurface of the superior articular facet, pedicle, and C2 body was observed. A classification system was used to better describe these relationships. Pedicle screws were then placed into selected examples of each type. RESULTS:We found type 0 specimens, with no cave, on 8 sides (10%). Types I, II, and III caves with minimal, moderate, and significant encroachment of the pedicle were observed on 40%, 35%, and 27.5% sides, respectively. Type IV caves with erosion into the lateral C2 body and undersurface of the superior articular facet were observed on 12.5% of sides. Although larger caves were found on left sides, this did not reach statistical significance. Pedicle screw placement for types III and IV were most likely to enter the vertebral artery cave (P < 0.05). CONCLUSIONS:Additional osteologic data regarding the course of the vertebral artery while within C2 may decrease morbidity during surgery in this region.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Tubbs RS,Granger A,Fisahn C,Loukas M,Moisi M,Iwanaga J,Paulson D,Jeyamohan S,Chapman JR,Oskouian RJdoi
10.1016/j.wneu.2016.07.037subject
Has Abstractpub_date
2016-10-01 00:00:00pages
368-374eissn
1878-8750issn
1878-8769pii
S1878-8750(16)30561-7journal_volume
94pub_type
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
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更新日期:2021-01-01 00:00:00
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doi:10.1016/j.wneu.2017.05.025
更新日期:2017-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2016-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.005
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.036
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.110
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.168
更新日期:2019-01-01 00:00:00
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journal_title:World neurosurgery
pub_type:
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更新日期:2020-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.095
更新日期:2016-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2021-01-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.084
更新日期:2018-06-01 00:00:00