Feasibility of C2 Lamina Screw Placement in a New Zealand Cohort: Computed Tomography Analysis According to Ethnicity and Gender.

IF 1.7 Q2 SURGERY
Richard N Storey, Joseph F Baker
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引用次数: 0

Abstract

Background: Previous analyses have suggested variations in cervical spine canal morphology according to ethnicity, possibly in part due to variations in the posterior elements. The potential for these variations to affect the placement of instrumentation is uncertain. The aim of this study was to report on the feasibility of C2 lamina screw insertion in a New Zealand cohort including analysis of Māori, the indigenous people of New Zealand.

Methods: A trauma computed tomography database was accessed to identify suitable images. On axial images, where the isthmus was at its widest, the outer diameter (OD) and inner diameter (ID) of the lamina were measured. Screw length was measured from a proposed entry point to the contralateral junction of the lamina and lateral mass. The spinolaminar angle was measured as the angle subtended by the screw trajectory and midsagittal plane. A 5.5-mm OD was accepted as a threshold for the feasibility of lamina screw placement.

Results: One hundred eighty-seven images were assessed: 115 New Zealand European and 72 Māori. The mean age of the cohort was 41.9 years (SD 19.6), and most patients (64%) were men. For the entire cohort, mean OD was 6.6 and 6.8 mm on the right and left, respectively; the mean inner diameter was 3.5 and 3.8 mm; mean screw length was 31.5 and 31.5 mm; and mean spinolaminar angle was 46.0° and 46.1°. C2 lamina screw placement was feasible in a majority of patients. Considering only Māori patients, placement was feasible in 96% of right and 94% of left laminae in men but 72% of right and 72% of left laminae in women.

Conclusions: In a majority of patients, C2 lamina screw placement is feasible. However, advanced imaging must be carefully assessed preoperatively because data suggest that Māori women may not necessarily have optimal anatomy.

Clinical relevance: Care needs to be taken when assessing and planning surgery inpatients of different ethnicities because variations may exist in the morphology of the posterior elements of C2, leading to variation in optimal fixation strategy.

Level of evidence: 3:

新西兰队列中 C2 腔螺钉植入的可行性:根据种族和性别进行计算机断层扫描分析。
背景:以前的分析表明,不同种族的人颈椎管形态存在差异,部分原因可能是后部元素的变化。这些差异对器械置放的潜在影响尚不确定。本研究旨在报告在新西兰队列中插入 C2 椎板螺钉的可行性,包括对新西兰原住民毛利人的分析:方法:访问创伤计算机断层扫描数据库以确定合适的图像。在峡部最宽的轴向图像上,测量了薄层的外径(OD)和内径(ID)。螺钉长度的测量是从拟进入点到对侧椎板和侧块交界处。脊柱板层角是根据螺钉轨迹与中矢状面的夹角测量的。5.5毫米的外径被认为是脊柱骨板螺钉置入可行性的阈值:结果:共评估了 187 张图像:115名新西兰欧裔和72名毛利人。患者的平均年龄为 41.9 岁(SD 19.6),大多数患者(64%)为男性。在整个组群中,右侧和左侧的平均外径分别为6.6毫米和6.8毫米;平均内径分别为3.5毫米和3.8毫米;平均螺钉长度分别为31.5毫米和31.5毫米;平均脊柱板角度分别为46.0°和46.1°。大多数患者都能进行 C2 椎板螺钉置入术。仅考虑毛利患者,在男性患者中,96%的右椎板和94%的左椎板可行螺钉置入,而在女性患者中,72%的右椎板和72%的左椎板可行螺钉置入:结论:在大多数患者中,C2 椎板螺钉置入是可行的。然而,术前必须仔细评估先进的成像技术,因为数据表明毛利女性不一定具有最佳的解剖结构。临床相关性在评估和规划不同种族患者的手术时需要注意,因为C2后部元素的形态可能存在差异,从而导致最佳固定策略的不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
162
期刊介绍: The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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