Skip to main content
main-content

20.06.2018 | Original Article | Ausgabe 11/2018

European Spine Journal 11/2018

Proposal for a new trajectory for subaxial cervical lateral mass screws

Zeitschrift:
European Spine Journal > Ausgabe 11/2018
Autoren:
Samer Amhaz-Escanlar, Alberto Jorge-Mora, Teresa Jorge-Mora, Manuel Febrero-Bande, Maximo-Alberto Diez-Ulloa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-018-5670-5) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Lateral mass screws combined with rods are the standard method for posterior cervical spine subaxial fixation. Several techniques have been described, among which the most used are Roy Camille, Magerl, Anderson and An. All of them are based on tridimensional angles. Reliability of freehand angle estimation remains poorly investigated. We propose a new technique based on on-site spatial references and compare it with previously described ones assessing screw length and neurovascular potential complications.

Methods

Four different lateral mass screw insertion techniques (Magerl, Anderson, An and the new described technique) were performed bilaterally, from C3 to C6, in ten human spine specimens. A drill tip guide wire was inserted as originally described for each trajectory, and screw length was measured. Exit point was examined, and potential vertebral artery or nerve root injury was assessed.

Results

Mean screw length was 14.05 mm using Magerl’s technique, 13.47 mm using Anderson’s, 12.8 mm using An’s and 17.03 mm using the new technique. Data analysis showed significantly longer lateral mass screw length using the new technique (p value < 0.00001). Nerve potential injury occurred 37 times using Magerl’s technique, 28 using Anderson’s, 13 using An’s and twice using the new technique. Vertebral artery potential injury occurred once using Magerl’s technique, 8 times using Anderson’s and none using either An’s or the new proposed technique. The risk of neurovascular complication was significantly lower using the new technique (p value < 0.01).

Conclusion

The new proposed technique allows for longer screws, maximizing purchase and stability, while lowering the complication rate.

Graphical abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Jetzt e.Med zum Sonderpreis bestellen!

Sichern Sie sich jetzt Ihr e.Med-Abo und sparen Sie 50 %!

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 11/2018

European Spine Journal 11/2018 Zur Ausgabe

Announcements

Announcements

  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.