Department of Neurosurgery, School of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Neurosurgery. 2010 Mar;66(3 Suppl Operative):173-7; discussion 177. doi: 10.1227/01.NEU.0000350982.03929.05.
Defining the anatomic zones for the placement of occiput-C1 transarticular screws is essential for patient safety.
The feasibility and accuracy of occiput-C1 transarticular screw placement were evaluated in this anatomical study of normal cadaveric specimens.
Sixteen measurements were determined for screw entry points, trajectories, and lengths for placement of transarticular screws, as applied in the technique described by Grob, on the craniovertebral junction segments (occiput-C2) of 16 fresh human cadaveric cervical spines and 41 computed tomographic reconstructions of the craniovertebral junction. Acceptable angles for screw positioning were measured on digital x-rays.
All 32 screws were placed accurately. As determined by dissection of the specimens, none of the screws penetrated the spinal canal. Screw insertion caused no fractures, and the integrity of the hypoglossal canal was maintained in all the disarticulated specimens.
Viable transarticular occiput-C1 screw placement is possible, despite variability of the anatomy of the occipital condyle.
为了患者安全，确定寰枕关节 C1 经关节螺钉的解剖区域至关重要。
本解剖学研究对正常尸体标本进行了寰枕关节 C1 经关节螺钉置入的可行性和准确性评估。
对 16 具新鲜人体颈椎尸体标本和 41 例寰枢椎 CT 重建标本的寰枢关节（寰椎 C2）进行了 Grob 描述的技术的寰枕关节 C1 经关节螺钉置入的进钉点、轨迹和长度进行了 16 项测量。对数字 X 射线进行了可接受的螺钉定位角度测量。
所有 32 颗螺钉均准确置入。通过对标本的解剖发现，没有螺钉穿透椎管。螺钉插入没有造成骨折，所有关节分离标本的舌下神经管完整性都得到了保持。
尽管枕骨髁的解剖结构存在变异性，但可行的寰枕关节 C1 经关节螺钉置入是可能的。
