Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients
Purpose To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status...
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| Veröffentlicht in: | European spine journal 2014-08, Vol.23 (8), p.1712-1719 |
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| container_title | European spine journal |
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| creator | Li, Xueshi Ai, Fuzhi Xia, Hong Wu, Zenghui Ma, Xiangyang Yin, Qingshui |
| description | Purpose
To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status between C1 and C2.
Methods
Radiographic and clinical data were obtained from the electronic medical record system. Studies were carried out to assess the accuracy of C1ALMS and C2APS placement, the screw insertion-associated clinical complications and the fusion status between C1 and C2. Placement of the screws was assessed using the modified All India Institute of Medical Sciences outcome-based classification.
Results
Two-hundred and twelve C1ALMS and 207 C2APS in 106 patients were assessed. The ideal accurate rates were 92.0 % (195) and 53.1 % (110), and the acceptable accurate rates were 97.6 % (207) and 87.0 % (180), respectively. One patient died postoperatively due to C2 screw misplacement. There were no symptoms of neurologic and vertebral artery injuries in the rest of the patients. 102 patients (97.1 %) achieved solid fusion between C1 and C2. No instrumentation failure due to delayed union or nonunion was observed.
Conclusion
C1ALMS placement in TARP-III procedures appears to be safe. The cortical breach rate of C2APS is high though clinically the neurovascular complication rate is similar to that of posterior atlantoaxial procedures. Advanced navigation strategies may help improve the accuracy of C2APS placement and decrease potential complications. |
| doi_str_mv | 10.1007/s00586-014-3353-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1554948674</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3386548211</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-b92353fe65ae04efc4d749d4f0c2550dff8b99e09ccf8e346091a371249444473</originalsourceid><addsrcrecordid>eNqNks9q3DAQxkVpaTZpH6CXIuilF7cjWbKt3sLSpguBhJCejVYeJwq25Uo2ZR-u79ZxnP6hEIguEprffN9IM4y9EfBBAJQfE4CuigyEyvJc55l6xjZC5TIDk8vnbANGQVaUwhyx45TuAIQ2ULxkR1JVeaVksWE_r2zjw02046133A4Nd50fvLMdtylhSj0OEw8Dn26RW-fmaN1h5UI_dgROPgyJh5ZvBd1PGH2IvLN0II2eRO7prfwbHLHxrkOeXMQffOysw3sXv7pcn15dZrvdjo8xOGzmiJ-45Wmam8NiI6DgI7lSRnrFXrS2S_j6YT9h3758vt5-zc4vznbb0_PMqVJP2d5I-p4WC20RFLZONaUyjWrBSa2hadtqbwyCca6tMFcFGGHzUkhlFK0yP2HvV10q6fuMaap7nxx2nR0wzKkWWhNaFaV6Ckqtq0BqQt_9h96FOQ70EKIU1ayUWLzFSrkYUorY1mP0vY2HWkC9jEG9jkFNY1AvY1AvRbx9UJ73PTZ_Mn73nQC5AolCww3Gf6wfVf0FQXu9Xg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1549234417</pqid></control><display><type>article</type><title>Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients</title><source>PubMed (Medline)</source><source>MEDLINE</source><source>SpringerLink</source><source>EZB Electronic Journals Library</source><creator>Li, Xueshi ; Ai, Fuzhi ; Xia, Hong ; Wu, Zenghui ; Ma, Xiangyang ; Yin, Qingshui</creator><creatorcontrib>Li, Xueshi ; Ai, Fuzhi ; Xia, Hong ; Wu, Zenghui ; Ma, Xiangyang ; Yin, Qingshui</creatorcontrib><description>Purpose
To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status between C1 and C2.
Methods
Radiographic and clinical data were obtained from the electronic medical record system. Studies were carried out to assess the accuracy of C1ALMS and C2APS placement, the screw insertion-associated clinical complications and the fusion status between C1 and C2. Placement of the screws was assessed using the modified All India Institute of Medical Sciences outcome-based classification.
Results
Two-hundred and twelve C1ALMS and 207 C2APS in 106 patients were assessed. The ideal accurate rates were 92.0 % (195) and 53.1 % (110), and the acceptable accurate rates were 97.6 % (207) and 87.0 % (180), respectively. One patient died postoperatively due to C2 screw misplacement. There were no symptoms of neurologic and vertebral artery injuries in the rest of the patients. 102 patients (97.1 %) achieved solid fusion between C1 and C2. No instrumentation failure due to delayed union or nonunion was observed.
Conclusion
C1ALMS placement in TARP-III procedures appears to be safe. The cortical breach rate of C2APS is high though clinically the neurovascular complication rate is similar to that of posterior atlantoaxial procedures. Advanced navigation strategies may help improve the accuracy of C2APS placement and decrease potential complications.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-014-3353-4</identifier><identifier>PMID: 24838426</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Aged ; Atlanto-Axial Joint - diagnostic imaging ; Atlanto-Axial Joint - surgery ; Bone Plates - standards ; Cervical Vertebrae - diagnostic imaging ; Cervical Vertebrae - surgery ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurosurgery ; Original Article ; Pedicle Screws - standards ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - prevention & control ; Radiography ; Spinal Fusion - instrumentation ; Spinal Fusion - standards ; Surgical Orthopedics ; Young Adult</subject><ispartof>European spine journal, 2014-08, Vol.23 (8), p.1712-1719</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-b92353fe65ae04efc4d749d4f0c2550dff8b99e09ccf8e346091a371249444473</citedby><cites>FETCH-LOGICAL-c475t-b92353fe65ae04efc4d749d4f0c2550dff8b99e09ccf8e346091a371249444473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-014-3353-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-014-3353-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24838426$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xueshi</creatorcontrib><creatorcontrib>Ai, Fuzhi</creatorcontrib><creatorcontrib>Xia, Hong</creatorcontrib><creatorcontrib>Wu, Zenghui</creatorcontrib><creatorcontrib>Ma, Xiangyang</creatorcontrib><creatorcontrib>Yin, Qingshui</creatorcontrib><title>Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status between C1 and C2.
Methods
Radiographic and clinical data were obtained from the electronic medical record system. Studies were carried out to assess the accuracy of C1ALMS and C2APS placement, the screw insertion-associated clinical complications and the fusion status between C1 and C2. Placement of the screws was assessed using the modified All India Institute of Medical Sciences outcome-based classification.
Results
Two-hundred and twelve C1ALMS and 207 C2APS in 106 patients were assessed. The ideal accurate rates were 92.0 % (195) and 53.1 % (110), and the acceptable accurate rates were 97.6 % (207) and 87.0 % (180), respectively. One patient died postoperatively due to C2 screw misplacement. There were no symptoms of neurologic and vertebral artery injuries in the rest of the patients. 102 patients (97.1 %) achieved solid fusion between C1 and C2. No instrumentation failure due to delayed union or nonunion was observed.
Conclusion
C1ALMS placement in TARP-III procedures appears to be safe. The cortical breach rate of C2APS is high though clinically the neurovascular complication rate is similar to that of posterior atlantoaxial procedures. Advanced navigation strategies may help improve the accuracy of C2APS placement and decrease potential complications.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Atlanto-Axial Joint - diagnostic imaging</subject><subject>Atlanto-Axial Joint - surgery</subject><subject>Bone Plates - standards</subject><subject>Cervical Vertebrae - diagnostic imaging</subject><subject>Cervical Vertebrae - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Pedicle Screws - standards</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - prevention & control</subject><subject>Radiography</subject><subject>Spinal Fusion - instrumentation</subject><subject>Spinal Fusion - standards</subject><subject>Surgical Orthopedics</subject><subject>Young Adult</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNks9q3DAQxkVpaTZpH6CXIuilF7cjWbKt3sLSpguBhJCejVYeJwq25Uo2ZR-u79ZxnP6hEIguEprffN9IM4y9EfBBAJQfE4CuigyEyvJc55l6xjZC5TIDk8vnbANGQVaUwhyx45TuAIQ2ULxkR1JVeaVksWE_r2zjw02046133A4Nd50fvLMdtylhSj0OEw8Dn26RW-fmaN1h5UI_dgROPgyJh5ZvBd1PGH2IvLN0II2eRO7prfwbHLHxrkOeXMQffOysw3sXv7pcn15dZrvdjo8xOGzmiJ-45Wmam8NiI6DgI7lSRnrFXrS2S_j6YT9h3758vt5-zc4vznbb0_PMqVJP2d5I-p4WC20RFLZONaUyjWrBSa2hadtqbwyCca6tMFcFGGHzUkhlFK0yP2HvV10q6fuMaap7nxx2nR0wzKkWWhNaFaV6Ckqtq0BqQt_9h96FOQ70EKIU1ayUWLzFSrkYUorY1mP0vY2HWkC9jEG9jkFNY1AvY1AvRbx9UJ73PTZ_Mn73nQC5AolCww3Gf6wfVf0FQXu9Xg</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Li, Xueshi</creator><creator>Ai, Fuzhi</creator><creator>Xia, Hong</creator><creator>Wu, Zenghui</creator><creator>Ma, Xiangyang</creator><creator>Yin, Qingshui</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients</title><author>Li, Xueshi ; Ai, Fuzhi ; Xia, Hong ; Wu, Zenghui ; Ma, Xiangyang ; Yin, Qingshui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-b92353fe65ae04efc4d749d4f0c2550dff8b99e09ccf8e346091a371249444473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Atlanto-Axial Joint - diagnostic imaging</topic><topic>Atlanto-Axial Joint - surgery</topic><topic>Bone Plates - standards</topic><topic>Cervical Vertebrae - diagnostic imaging</topic><topic>Cervical Vertebrae - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Pedicle Screws - standards</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - prevention & control</topic><topic>Radiography</topic><topic>Spinal Fusion - instrumentation</topic><topic>Spinal Fusion - standards</topic><topic>Surgical Orthopedics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xueshi</creatorcontrib><creatorcontrib>Ai, Fuzhi</creatorcontrib><creatorcontrib>Xia, Hong</creatorcontrib><creatorcontrib>Wu, Zenghui</creatorcontrib><creatorcontrib>Ma, Xiangyang</creatorcontrib><creatorcontrib>Yin, Qingshui</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xueshi</au><au>Ai, Fuzhi</au><au>Xia, Hong</au><au>Wu, Zenghui</au><au>Ma, Xiangyang</au><au>Yin, Qingshui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>23</volume><issue>8</issue><spage>1712</spage><epage>1719</epage><pages>1712-1719</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
To investigate the (1) radiographic and clinical accuracy of C1 anterior lateral mass screw (C1ALMS) and C2 anterior pedicle screw (C2APS) placement in the transoral atlantoaxial reduction plate (TARP)-III procedure, (2) screw insertion-associated clinical complications and (3) fusion status between C1 and C2.
Methods
Radiographic and clinical data were obtained from the electronic medical record system. Studies were carried out to assess the accuracy of C1ALMS and C2APS placement, the screw insertion-associated clinical complications and the fusion status between C1 and C2. Placement of the screws was assessed using the modified All India Institute of Medical Sciences outcome-based classification.
Results
Two-hundred and twelve C1ALMS and 207 C2APS in 106 patients were assessed. The ideal accurate rates were 92.0 % (195) and 53.1 % (110), and the acceptable accurate rates were 97.6 % (207) and 87.0 % (180), respectively. One patient died postoperatively due to C2 screw misplacement. There were no symptoms of neurologic and vertebral artery injuries in the rest of the patients. 102 patients (97.1 %) achieved solid fusion between C1 and C2. No instrumentation failure due to delayed union or nonunion was observed.
Conclusion
C1ALMS placement in TARP-III procedures appears to be safe. The cortical breach rate of C2APS is high though clinically the neurovascular complication rate is similar to that of posterior atlantoaxial procedures. Advanced navigation strategies may help improve the accuracy of C2APS placement and decrease potential complications.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24838426</pmid><doi>10.1007/s00586-014-3353-4</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0940-6719 |
| ispartof | European spine journal, 2014-08, Vol.23 (8), p.1712-1719 |
| issn | 0940-6719 1432-0932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1554948674 |
| source | PubMed (Medline); MEDLINE; SpringerLink; EZB Electronic Journals Library |
| subjects | Adolescent Adult Aged Atlanto-Axial Joint - diagnostic imaging Atlanto-Axial Joint - surgery Bone Plates - standards Cervical Vertebrae - diagnostic imaging Cervical Vertebrae - surgery Child Child, Preschool Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Middle Aged Neurosurgery Original Article Pedicle Screws - standards Postoperative Complications - diagnostic imaging Postoperative Complications - prevention & control Radiography Spinal Fusion - instrumentation Spinal Fusion - standards Surgical Orthopedics Young Adult |
| title | Radiographic and clinical assessment on the accuracy and complications of C1 anterior lateral mass and C2 anterior pedicle screw placement in the TARP-III procedure: a study of 106 patients |
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