Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (9): 1526-1529.doi: 10.3969/j.issn.1673-8225.2012.09.002

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Three dimensional CT study on relevant parameters of atlas pedicle screw insertion

He Hong-wei1, 2, Sui Tong1, Zhao Hui-yi3, Chen Li-jun1, Lin Qing-chi1, Duan Shao-yin1   

  1. 1Department of Imaging, Zhongshan Hospital of Xiamen University, Xiamen  361004, Fujian Province, China; 2Department of Imaging, First Hospital of Ningbo, Ningbo  315010, Zhejiang Province, China; 3Department of Orthopedics, Zhongshan Hospital of Xiamen University, Xiamen  361004, Fujian Province, China
  • Received:2011-10-27 Revised:2011-11-12 Online:2012-02-26 Published:2012-02-26
  • Contact: Duan Shao-yin, Doctor, Professor, Department of Imaging, Zhongshan Hospital of Xiamen University, Xiamen 361004, Fujian Province, China xmdsy@xmu.edu.cn
  • About author:He Hong-wei★, Master, Attending physician, Department of Imaging, Zhongshan Hospital of Xiamen University, Xiamen 361004, Fujian Province, China; Department of Imaging, First Hospital of Ningbo, Ningbo 315010, Zhejiang Province, China
  • Supported by:

     the National Natural Science Foundation of China, No. 30870690*

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Abstract:

BACKGROUND: As for studies on entry point and trajectory transverse angle of atlas pedicle screw insertion, different authors obtain different data.
OBJECTIVE: To design an ideal route of screw insertion by CT multi-planar reconstruction (MPR), to measure parameters related to atlas pedicle screw insertion, and to evaluate effect of the height of the atlas pedicle screw and variation of atlas ponticulus on the pedicle screw insertion.
METHODS: Sixty-two subjects who were performed computed tomography angiography in head and neck without any pathology of craniocervical junction from October 1, 2009 to June 30, 2010 were selected from the picture archiving and communication system. Their axial images were used to reconstruct the images by MPR techniques. The parameters were obtained including the pedicle minimum height, location of optimal insertion point, trajectory transverse angle, the maximum length of the trajectory and the length of trajectory in atlas pedicle. The incidence of atlas ponticulus was analyzed.
RESULTS AND CONCLUSION: The minimum height of atlas pedicle was (3.8±0.8) mm in female and (4.4±1.2) mm in male, 91.1% of the subjects were equal to or over 3.0 mm. The distance from screw insertion point to midline was (20.8±1.3) mm in female and (21.7±1.2) mm in male. The trajectory transverse angle was (10.3±2.6)° in female and (10.1±2.1) ° in male. The maximum length of the trajectory was (26.5±1.8) mm in female and (26.9±1.8) mm in male. The length of trajectory in atlas pedicle was (7.9±1.2) mm in female and (8.0±1.1) mm in male. The incidence of atlas ponticulus was 25.8%, of which typeⅡ-Ⅳ accounts for 21.0%.It is indicated that the minimum height of atlas pedicle screw and type Ⅱ-Ⅳ posterior ponticulus can directly affect the screw insertion, and MPR imaging can devise the ideal trajectory for pedicle screw insertion, which is necessary for three-dimensional CT anatomical measurement before atlatoaxial joint screw insertion.

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