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Research ArticleArticles

Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation

Richard P. Menger, Christopher M. Storey, Menarvia K.C. Nixon, Justin Haydel, Anil Nanda and Anthony Sin
International Journal of Spine Surgery January 2015, 9 43; DOI: https://doi.org/10.14444/2043
Richard P. Menger
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD
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Christopher M. Storey
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD, PhD
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Menarvia K.C. Nixon
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD
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Justin Haydel
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD
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Anil Nanda
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD, MPH, FACS
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Anthony Sin
Department of Neurosurgery, Louisiana State University of Health Sciences, Shreveport LA
MD
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Article Figures & Data

Figures

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  • Fig. 1
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    Fig. 1

    Coronal C1 Pedicle Screw Entry Point.

  • Fig. 2
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    Fig. 2

    Axial C1 Pedicle Screw Entry Point.

  • Fig. 3
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    Fig. 3

    Axial Trajectory of C1 Pedicle Screw.

  • Fig. 4
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    Fig. 4

    Sagittal CT Illustrating C1-2-3 Fixation with C1 Pedicle Screw Technique.

  • Fig. 5
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    Fig. 5

    Post-operative Lateral Cervical X-ray Showing C1-2 Pedicle Screw Fixation.

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    Fig. 6

    Failure of Odontoid Screw Fixation at 10 months.

  • Fig. 7
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    Fig. 7

    Axial CT Pedicle Width Measurement on a Patient with C1 Pedicle Screw Placement Failure.

  • Fig. 8
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    Fig. 8

    C1 Laminar Wiring Following Failure to Place C1 Pedicle Screw.

Tables

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    Table 1

    64 Patients Undergoing Cranio-vertebral Junction Instrumentation.

    ProcedureCase
    Occipital-Cervical Fusion40
    C2-to cervical or thoracic fusion15
    C1 to cervical or thoracic fusion4
    C1-C2 fixation5
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    Table 2

    Patients Undergoing C1 Pedicle Screw Fixation.

    PatientProcedureIndicationPresentationC1 Pedicle Screw OutcomeBlood loss (C1-C2)C1 Posterior Arch HeightC1 Pedicle Width
    73FC1-T2 fusionOncologicC2 and C7 metSuccessful-3.8mmR 4.11mm
    L 4.06mm
    22MC1-2 fusionTraumaC1-2 distractionSuccessful100cc4.13mmR 5.16 mm
    L 4.89 mm
    76FO-T1 fusionTraumaC1-2 subluxSuccessful-4.43mmR 4.06mm
    L 5.23mm
    78FC1-2 fusionTraumaType II OdontoidSuccessful200cc4.29mmR 4.20mm
    L 4.53mm
    67MC1-4 fusionOncologicC2 metastaticSuccessful-4.7mmR 5.4mm
    L 5.9mm
    31MC1-3 fusionTraumaC2 fractureSuccessful-5.67mmR 8.70mm
    L 7.61mm
    73MC1-2 fusionTraumaType II OdontoidSuccessful100cc4.1mmR 6.7mm
    L 6.6mm
    83FC1-2 fusionTraumaType II OdontoidSuccessful100cc3.9mmR 5.0mm
    L 5.2mm
    35MC1-2 fusionTraumaOdontoid screw failure, Old Type II Odontoid fxFailure300cc3.94 mmR 2.78mm
    L 4.42mm
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International Journal of Spine Surgery
Vol. 9
1 Jan 2015
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Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation
Richard P. Menger, Christopher M. Storey, Menarvia K.C. Nixon, Justin Haydel, Anil Nanda, Anthony Sin
International Journal of Spine Surgery Jan 2015, 9 43; DOI: 10.14444/2043

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Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation
Richard P. Menger, Christopher M. Storey, Menarvia K.C. Nixon, Justin Haydel, Anil Nanda, Anthony Sin
International Journal of Spine Surgery Jan 2015, 9 43; DOI: 10.14444/2043
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Keywords

  • C1-C2 instrumentation
  • lateral mass screw
  • pedicle screw
  • pars interarticularis screw

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