Accuracy of Axis Drill Guides in the Cases of Atlantoaxial Instabilities Associated With High-Riding Vertebral Arteries, Narrow Pedicles, and Complex Deformities: Comparison of 3 Fixation Methods
WORLD NEUROSURGERY, cilt.168, 2022 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 168
- Basım Tarihi: 2022
- Doi Numarası: 10.1016/j.wneu.2022.10.007
- Dergi Adı: WORLD NEUROSURGERY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Index Islamicus, MEDLINE, Veterinary Science Database
- Gazi Üniversitesi Adresli: Hayır
Özet
-OBJECTIVE: To contrast the accuracy of C2 navigation template -assisted versus freehand pedicle and/or pars screw fixation in high-risk cases where a high-riding vertebral artery (VA) or narrow pedicle and complex de-formities were associated.-METHODS: In our hospital, computed tomography (CT) data of 30 patients with pathology on C0-1-2, who had risk factors for VA injury, that were complex cervical de-formities, atlantoaxial instabilities with narrow C2 pedicle and/or HRVA variations were retrospectively reviewed. Using computer-aided design software and desktop printer we printed 3 sets of high cervical models per case. We divided them into 3 groups using 3 different C2 screw fix-ation techniques: the freehand pars screw fixation group, the freehand pedicle screw fixation group, and the navi-gation template -assisted pedicle screw fixation group. After 180 screw placements were finished, the parts un-derwent a CT scan. Then the breach rates on postoperative scans were measured.-RESULTS: Our results showed that the accurate place-ment rate is not noticeably different between navigation template -assisted and freehand pedicle screws, where the high-riding vertebral artery and narrow pedicles were associated, but was better in the navigational template group with complex deformities. Pars screws were found to be superior in terms of accuracy.-CONCLUSIONS: The current study suggests that navi-gational template -assisted pedicle screws are risky for high-risk individuals with abnormal anatomy, such as those with a high-riding vertebral artery, a narrow pedicle, and complex abnormalities, and alternative C2 pars screws may be a reliable option for such individuals.