Comparison of the anatomic risk for vertebral artery injury associated with percutaneous atlantoaxial anterior and posterior transarticular screws

doi:10.1016/j.spinee.2012.05.010

科研成果详情

题名	Comparison of the anatomic risk for vertebral artery injury associated with percutaneous atlantoaxial anterior and posterior transarticular screws
作者	Xu, Hui; Chi, Yong L.; Wang, Xiang Y.; Dou, Hai C.; Wang, Sheng; Huang, Yi X.; Xu, Hua Z.
发表日期	2012-08
发表期刊	SPINE JOURNAL 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Atlantoaxial Anterior transarticular screw Posterior transarticular screw Vertebral artery injury Minimally invasive spine surgery
其他关键词	CERVICAL-SPINE SURGERY ; FIXATION ; FUSION ; C1-C2 ; STABILIZATION ; INSTABILITY
摘要	BACKGROUND CONTEXT: As a minimally invasive spine surgery, percutaneous atlantoaxial fixation techniques using anterior transarticular screw (ATS) and posterior transarticular screw (PTS) have promising clinical results. However, transarticular screw fixation is technically demanding and carries a potential risk of iatrogenic vertebral artery (VA) injury. There were no available data comparing the anatomic risk of VA injury associated with these screws. PURPOSE: To evaluate the trajectories of percutaneous atlantoaxial ATS and PTS through three-dimensional (3D) computerized tomography. STUDY DESIGN: To compare the anatomic risk of VA injury between percutaneous ATS and PTS. PATIENT SAMPLE: Sixty patients ranged in age from 19 to 75 years (mean, 45.08 years) and included 35 men and 25 women. OUTCOME MEASURES: Image measurement of C2 isthmus height and C2 isthmus width and the distance between the medial-most superior articular facet to the medial-most edge of the VA groove of the C2 (D). METHODS: Sixty consecutive patients (in total) with lower cervical lesions were evaluated through 3D images reconstructed by a rapid 3D system. The maximum possible diameters of the percutaneous atlantoaxial ATS and PTS trajectories were compared and examined. Mean, range, and standard deviations for each type of screw, for left and right trajectories, and for men and women were calculated from 120 percutaneous atlantoaxial ATS and PTS measurements through SPSS. RESULTS: The maximum mean diameter differed significantly between the trajectories of 120 percutaneous atlantoaxial ATS and PTS. For screw trajectories <= 3.5 mm in diameter, 19.2% of the PTS trajectories were judged as risky, whereas all the anterior ones were judged as safe. CONCLUSIONS: From an anatomic perspective, percutaneous ATS fixation poses less anatomic risk of VA injury than percutaneous PTS fixation. As an alternative surgical therapy for atlantoaxial subluxation, percutaneous ATS fixation may play a more important role in the future. (c) 2012 Elsevier Inc. All rights reserved.
资助项目	National Natural Sciences of ChinaNational Natural Science Foundation of China (NSFC) [30970702]; Wenzhou Municipal Science and Technology Agency [Y20090271]
出版者	ELSEVIER SCIENCE INC
出版地	NEW YORK
ISSN	1529-9430
EISSN	1878-1632
卷号	12 期号:8 页码:656-662
DOI	10.1016/j.spinee.2012.05.010
页数	7
WOS类目	Clinical Neurology ; Orthopedics
WOS研究方向	Neurosciences & Neurology ; Orthopedics
WOS记录号	WOS:000309527800007
收录类别	SCIE ; PUBMED
URL	查看原文
PubMed ID	22728075
通讯作者地址	[Xu, Hua Z.]Wenzhou Med Coll, Affiliated Hosp 2, Dept Spinal Surg, 109 Xueyuanxi Rd, Wenzhou 325027, Peoples R China.
TOP期刊	TOP期刊
引用统计	被引频次：18[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/11642
专题	第二临床医学院、附属第二医院、育英儿童医院附属第二医院附属第二医院_脊柱外科
通讯作者	Xu, Hua Z.
作者单位	Wenzhou Med Coll, Affiliated Hosp 2, Dept Spinal Surg, Wenzhou 325027, Peoples R China
第一作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 脊柱外科
通讯作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 脊柱外科
第一作者的第一单位	附属第二医院
推荐引用方式 GB/T 7714	Xu, Hui,Chi, Yong L.,Wang, Xiang Y.,et al. Comparison of the anatomic risk for vertebral artery injury associated with percutaneous atlantoaxial anterior and posterior transarticular screws[J]. SPINE JOURNAL,2012,12(8):656-662.
APA	Xu, Hui., Chi, Yong L.., Wang, Xiang Y.., Dou, Hai C.., Wang, Sheng., ... & Xu, Hua Z.. (2012). Comparison of the anatomic risk for vertebral artery injury associated with percutaneous atlantoaxial anterior and posterior transarticular screws. SPINE JOURNAL, 12(8), 656-662.
MLA	Xu, Hui,et al."Comparison of the anatomic risk for vertebral artery injury associated with percutaneous atlantoaxial anterior and posterior transarticular screws".SPINE JOURNAL 12.8(2012):656-662.