Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination
Background C1 transpedicular screw (C1TS) placement provided satisfactory pullout resistance and 3D stability, but its application might be limited in patients with basilar invagination (BI) due to the high incidences of the atlas anomaly and vertebral artery (VA) variation. However, no study has ex...
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| description | Background
C1 transpedicular screw (C1TS) placement provided satisfactory pullout resistance and 3D stability, but its application might be limited in patients with basilar invagination (BI) due to the high incidences of the atlas anomaly and vertebral artery (VA) variation. However, no study has explored the classifications of C1 posterior arch variations and investigated their indications and ideal insertion trajectories for C1TS in BI.
Purpose
To investigate the bony and surrounding arterial characteristics of the atlas, classify posterior arch variations, identify indications for C1TS, evaluate ideal insertion trajectories for C1TS in BI patients without atlas occipitalization (AO), and compare them with those without BI and AO as control.
Methods
A total of 130 non-AO patients with and without BI (52 patients and 78 patients, respectively) from two medical centers were included at a 1:1.5 ratio. The posterior arch variations were assessed using a modified C1 morphological classification. Comparisons regarding the bony and surrounding arterial characteristics, morphological classification distributions, and ideal insertion trajectories between BI and control groups were performed. The subgroup analyses based on different morphological classifications were also conducted. In addition, the factors possibly affecting the insertion parameters were investigated using multiple linear regression analyses.
Results
The BI group was associated with significantly smaller lateral mass height and width, sagittal length of posterior arch, pedicle height, vertical height of posterior arch, and distance between VA and VA groove (VAG) than control group. Four types of posterior arch variations with indications for different screw placement techniques were classified; Classifications I and II were suitable for C1TS. The BI cohort showed a significantly lower rate of Classification I than the control cohort. In the BI group, the subgroup of Classification I had significantly larger distance between the insertion point (IP) and inferior aspect of the posterior arch. In addition, it had the narrowest width along ideal screw trajectory, but a significantly more lateral ideal mediolateral angle than the subgroup of Classification II. Multiple linear regression indicated that the cephalad angle was significantly associated with the diagnosis of BI (
B
= 3.708,
P
|
| doi_str_mv | 10.1007/s00586-023-07873-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2845105373</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2845105373</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-882571ef3e9eb36eef55e432fadcb7ee0cec55e49041d98d1db3a230cce03dc23</originalsourceid><addsrcrecordid>eNp9kU2O1DAQhS0EYpqBC7BAltiwCZTtOImXqDX8SCOxgbXlOJVpj9J2sJ1ucRKui9MZQGLBynbV915Z9Qh5yeAtA2jfJQDZNRVwUUHbtaKqH5EdqwWvQAn-mOxA1VA1LVNX5FlK9wBMKmiekivRSgFKsh35uT-YaGzG6FJ2NlHjB4onMy0mu-BpGOme0TmklQiRmmgP9GSi29pjKeVofJpxcHaZTKTJRjzTeTIWj-gz7TGfET2di6K8Ez27fLiMWS9hKYRJblU6fzJ3zl-cn5Mno5kSvng4r8m3Dzdf95-q2y8fP-_f31ZW8CZXXcdly3AUqLAXDeIoJZYNjGawfYsIFu1aUVCzQXUDG3phuABrEcRgubgmbzbfOYbvC6asjy5ZnCbjMSxJ866WDKRoRUFf_4PehyX68rtCtXVTlqpUofhG2RhSijjqObqjiT80A73GprfYdIlNX2LTdRG9erBe-iMOfyS_cyqA2IBUWv4O49_Z_7H9BeYzp1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2874637599</pqid></control><display><type>article</type><title>Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Zhou, Lu-Ping ; Zhao, Chen-Hao ; Zhang, Zhi-Gang ; Shang, Jin ; Zhang, Hua-Qing ; Ma, Fang ; Jia, Chong-Yu ; Zhang, Ren-Jie ; Shen, Cai-Liang</creator><creatorcontrib>Zhou, Lu-Ping ; Zhao, Chen-Hao ; Zhang, Zhi-Gang ; Shang, Jin ; Zhang, Hua-Qing ; Ma, Fang ; Jia, Chong-Yu ; Zhang, Ren-Jie ; Shen, Cai-Liang</creatorcontrib><description>Background
C1 transpedicular screw (C1TS) placement provided satisfactory pullout resistance and 3D stability, but its application might be limited in patients with basilar invagination (BI) due to the high incidences of the atlas anomaly and vertebral artery (VA) variation. However, no study has explored the classifications of C1 posterior arch variations and investigated their indications and ideal insertion trajectories for C1TS in BI.
Purpose
To investigate the bony and surrounding arterial characteristics of the atlas, classify posterior arch variations, identify indications for C1TS, evaluate ideal insertion trajectories for C1TS in BI patients without atlas occipitalization (AO), and compare them with those without BI and AO as control.
Methods
A total of 130 non-AO patients with and without BI (52 patients and 78 patients, respectively) from two medical centers were included at a 1:1.5 ratio. The posterior arch variations were assessed using a modified C1 morphological classification. Comparisons regarding the bony and surrounding arterial characteristics, morphological classification distributions, and ideal insertion trajectories between BI and control groups were performed. The subgroup analyses based on different morphological classifications were also conducted. In addition, the factors possibly affecting the insertion parameters were investigated using multiple linear regression analyses.
Results
The BI group was associated with significantly smaller lateral mass height and width, sagittal length of posterior arch, pedicle height, vertical height of posterior arch, and distance between VA and VA groove (VAG) than control group. Four types of posterior arch variations with indications for different screw placement techniques were classified; Classifications I and II were suitable for C1TS. The BI cohort showed a significantly lower rate of Classification I than the control cohort. In the BI group, the subgroup of Classification I had significantly larger distance between the insertion point (IP) and inferior aspect of the posterior arch. In addition, it had the narrowest width along ideal screw trajectory, but a significantly more lateral ideal mediolateral angle than the subgroup of Classification II. Multiple linear regression indicated that the cephalad angle was significantly associated with the diagnosis of BI (
B
= 3.708,
P
< 0.001) and sagittal diameter of C1 (
B
= 3.417,
P
= 0.027); the ideal mediolateral angle was significantly associated with BMI (
B
= 0.264,
P
= 0.031), sagittal diameter of C1 (
B
= − 4.559,
P
= 0.002), and pedicle height (
B
= − 2.317,
P
< 0.001); the distance between the IP and inferior aspects of posterior arch was significantly associated with age (
B
= − 0.002,
P
= 0.035), BMI (
B
= − 0.007,
P
= 0.028), sagittal length of posterior arch (
B
= − 0.187,
P
= 0.032), pedicle height (
B
= − 0.392,
P
< 0.001), and middle and lower parts of posterior arch (
B
= 0.862,
P
< 0.001).
Conclusion
The incidence of posterior arch variation in BI patients without AO was remarkably higher than that in control patients. The insertion parameters of posterior screws were different between the morphological classification types in BI and control groups. The distance between VA V3 segments and VAG in BI cohort was substantially smaller than that in control cohort. Preoperative individual 3D computed tomography (CT), CT angiography and intraoperative navigation are recommended for BI patients receiving posterior screw placement.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-023-07873-4</identifier><identifier>PMID: 37530951</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Angiography ; Atlanto-Axial Joint - surgery ; Bone Screws ; Classification ; Computed tomography ; Computed Tomography Angiography ; Humans ; Medicine ; Medicine & Public Health ; Morphology ; Neurosurgery ; Original Article ; Physical characteristics ; Platybasia ; Regression analysis ; Spinal Fusion - methods ; Surgical Orthopedics ; Tomography, X-Ray Computed ; Variation ; Vertebrae</subject><ispartof>European spine journal, 2023-10, Vol.32 (10), p.3547-3560</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-882571ef3e9eb36eef55e432fadcb7ee0cec55e49041d98d1db3a230cce03dc23</cites><orcidid>0009-0004-7733-0304 ; 0000-0002-2309-2855 ; 0000-0002-1519-9919 ; 0000-0001-5282-769X ; 0000-0002-4269-5520 ; 0000-0002-9835-6384 ; 0000-0002-7203-5769 ; 0000-0003-4922-9255</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-023-07873-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-023-07873-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37530951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Lu-Ping</creatorcontrib><creatorcontrib>Zhao, Chen-Hao</creatorcontrib><creatorcontrib>Zhang, Zhi-Gang</creatorcontrib><creatorcontrib>Shang, Jin</creatorcontrib><creatorcontrib>Zhang, Hua-Qing</creatorcontrib><creatorcontrib>Ma, Fang</creatorcontrib><creatorcontrib>Jia, Chong-Yu</creatorcontrib><creatorcontrib>Zhang, Ren-Jie</creatorcontrib><creatorcontrib>Shen, Cai-Liang</creatorcontrib><title>Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Background
C1 transpedicular screw (C1TS) placement provided satisfactory pullout resistance and 3D stability, but its application might be limited in patients with basilar invagination (BI) due to the high incidences of the atlas anomaly and vertebral artery (VA) variation. However, no study has explored the classifications of C1 posterior arch variations and investigated their indications and ideal insertion trajectories for C1TS in BI.
Purpose
To investigate the bony and surrounding arterial characteristics of the atlas, classify posterior arch variations, identify indications for C1TS, evaluate ideal insertion trajectories for C1TS in BI patients without atlas occipitalization (AO), and compare them with those without BI and AO as control.
Methods
A total of 130 non-AO patients with and without BI (52 patients and 78 patients, respectively) from two medical centers were included at a 1:1.5 ratio. The posterior arch variations were assessed using a modified C1 morphological classification. Comparisons regarding the bony and surrounding arterial characteristics, morphological classification distributions, and ideal insertion trajectories between BI and control groups were performed. The subgroup analyses based on different morphological classifications were also conducted. In addition, the factors possibly affecting the insertion parameters were investigated using multiple linear regression analyses.
Results
The BI group was associated with significantly smaller lateral mass height and width, sagittal length of posterior arch, pedicle height, vertical height of posterior arch, and distance between VA and VA groove (VAG) than control group. Four types of posterior arch variations with indications for different screw placement techniques were classified; Classifications I and II were suitable for C1TS. The BI cohort showed a significantly lower rate of Classification I than the control cohort. In the BI group, the subgroup of Classification I had significantly larger distance between the insertion point (IP) and inferior aspect of the posterior arch. In addition, it had the narrowest width along ideal screw trajectory, but a significantly more lateral ideal mediolateral angle than the subgroup of Classification II. Multiple linear regression indicated that the cephalad angle was significantly associated with the diagnosis of BI (
B
= 3.708,
P
< 0.001) and sagittal diameter of C1 (
B
= 3.417,
P
= 0.027); the ideal mediolateral angle was significantly associated with BMI (
B
= 0.264,
P
= 0.031), sagittal diameter of C1 (
B
= − 4.559,
P
= 0.002), and pedicle height (
B
= − 2.317,
P
< 0.001); the distance between the IP and inferior aspects of posterior arch was significantly associated with age (
B
= − 0.002,
P
= 0.035), BMI (
B
= − 0.007,
P
= 0.028), sagittal length of posterior arch (
B
= − 0.187,
P
= 0.032), pedicle height (
B
= − 0.392,
P
< 0.001), and middle and lower parts of posterior arch (
B
= 0.862,
P
< 0.001).
Conclusion
The incidence of posterior arch variation in BI patients without AO was remarkably higher than that in control patients. The insertion parameters of posterior screws were different between the morphological classification types in BI and control groups. The distance between VA V3 segments and VAG in BI cohort was substantially smaller than that in control cohort. Preoperative individual 3D computed tomography (CT), CT angiography and intraoperative navigation are recommended for BI patients receiving posterior screw placement.</description><subject>Angiography</subject><subject>Atlanto-Axial Joint - surgery</subject><subject>Bone Screws</subject><subject>Classification</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morphology</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Physical characteristics</subject><subject>Platybasia</subject><subject>Regression analysis</subject><subject>Spinal Fusion - methods</subject><subject>Surgical Orthopedics</subject><subject>Tomography, X-Ray Computed</subject><subject>Variation</subject><subject>Vertebrae</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU2O1DAQhS0EYpqBC7BAltiwCZTtOImXqDX8SCOxgbXlOJVpj9J2sJ1ucRKui9MZQGLBynbV915Z9Qh5yeAtA2jfJQDZNRVwUUHbtaKqH5EdqwWvQAn-mOxA1VA1LVNX5FlK9wBMKmiekivRSgFKsh35uT-YaGzG6FJ2NlHjB4onMy0mu-BpGOme0TmklQiRmmgP9GSi29pjKeVofJpxcHaZTKTJRjzTeTIWj-gz7TGfET2di6K8Ez27fLiMWS9hKYRJblU6fzJ3zl-cn5Mno5kSvng4r8m3Dzdf95-q2y8fP-_f31ZW8CZXXcdly3AUqLAXDeIoJZYNjGawfYsIFu1aUVCzQXUDG3phuABrEcRgubgmbzbfOYbvC6asjy5ZnCbjMSxJ866WDKRoRUFf_4PehyX68rtCtXVTlqpUofhG2RhSijjqObqjiT80A73GprfYdIlNX2LTdRG9erBe-iMOfyS_cyqA2IBUWv4O49_Z_7H9BeYzp1Q</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Zhou, Lu-Ping</creator><creator>Zhao, Chen-Hao</creator><creator>Zhang, Zhi-Gang</creator><creator>Shang, Jin</creator><creator>Zhang, Hua-Qing</creator><creator>Ma, Fang</creator><creator>Jia, Chong-Yu</creator><creator>Zhang, Ren-Jie</creator><creator>Shen, Cai-Liang</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>7X8</scope><orcidid>https://orcid.org/0009-0004-7733-0304</orcidid><orcidid>https://orcid.org/0000-0002-2309-2855</orcidid><orcidid>https://orcid.org/0000-0002-1519-9919</orcidid><orcidid>https://orcid.org/0000-0001-5282-769X</orcidid><orcidid>https://orcid.org/0000-0002-4269-5520</orcidid><orcidid>https://orcid.org/0000-0002-9835-6384</orcidid><orcidid>https://orcid.org/0000-0002-7203-5769</orcidid><orcidid>https://orcid.org/0000-0003-4922-9255</orcidid></search><sort><creationdate>20231001</creationdate><title>Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination</title><author>Zhou, Lu-Ping ; Zhao, Chen-Hao ; Zhang, Zhi-Gang ; Shang, Jin ; Zhang, Hua-Qing ; Ma, Fang ; Jia, Chong-Yu ; Zhang, Ren-Jie ; Shen, Cai-Liang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-882571ef3e9eb36eef55e432fadcb7ee0cec55e49041d98d1db3a230cce03dc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Angiography</topic><topic>Atlanto-Axial Joint - surgery</topic><topic>Bone Screws</topic><topic>Classification</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morphology</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Physical characteristics</topic><topic>Platybasia</topic><topic>Regression analysis</topic><topic>Spinal Fusion - methods</topic><topic>Surgical Orthopedics</topic><topic>Tomography, X-Ray Computed</topic><topic>Variation</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Lu-Ping</creatorcontrib><creatorcontrib>Zhao, Chen-Hao</creatorcontrib><creatorcontrib>Zhang, Zhi-Gang</creatorcontrib><creatorcontrib>Shang, Jin</creatorcontrib><creatorcontrib>Zhang, Hua-Qing</creatorcontrib><creatorcontrib>Ma, Fang</creatorcontrib><creatorcontrib>Jia, Chong-Yu</creatorcontrib><creatorcontrib>Zhang, Ren-Jie</creatorcontrib><creatorcontrib>Shen, Cai-Liang</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</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 Edition)</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>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Lu-Ping</au><au>Zhao, Chen-Hao</au><au>Zhang, Zhi-Gang</au><au>Shang, Jin</au><au>Zhang, Hua-Qing</au><au>Ma, Fang</au><au>Jia, Chong-Yu</au><au>Zhang, Ren-Jie</au><au>Shen, Cai-Liang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>32</volume><issue>10</issue><spage>3547</spage><epage>3560</epage><pages>3547-3560</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Background
C1 transpedicular screw (C1TS) placement provided satisfactory pullout resistance and 3D stability, but its application might be limited in patients with basilar invagination (BI) due to the high incidences of the atlas anomaly and vertebral artery (VA) variation. However, no study has explored the classifications of C1 posterior arch variations and investigated their indications and ideal insertion trajectories for C1TS in BI.
Purpose
To investigate the bony and surrounding arterial characteristics of the atlas, classify posterior arch variations, identify indications for C1TS, evaluate ideal insertion trajectories for C1TS in BI patients without atlas occipitalization (AO), and compare them with those without BI and AO as control.
Methods
A total of 130 non-AO patients with and without BI (52 patients and 78 patients, respectively) from two medical centers were included at a 1:1.5 ratio. The posterior arch variations were assessed using a modified C1 morphological classification. Comparisons regarding the bony and surrounding arterial characteristics, morphological classification distributions, and ideal insertion trajectories between BI and control groups were performed. The subgroup analyses based on different morphological classifications were also conducted. In addition, the factors possibly affecting the insertion parameters were investigated using multiple linear regression analyses.
Results
The BI group was associated with significantly smaller lateral mass height and width, sagittal length of posterior arch, pedicle height, vertical height of posterior arch, and distance between VA and VA groove (VAG) than control group. Four types of posterior arch variations with indications for different screw placement techniques were classified; Classifications I and II were suitable for C1TS. The BI cohort showed a significantly lower rate of Classification I than the control cohort. In the BI group, the subgroup of Classification I had significantly larger distance between the insertion point (IP) and inferior aspect of the posterior arch. In addition, it had the narrowest width along ideal screw trajectory, but a significantly more lateral ideal mediolateral angle than the subgroup of Classification II. Multiple linear regression indicated that the cephalad angle was significantly associated with the diagnosis of BI (
B
= 3.708,
P
< 0.001) and sagittal diameter of C1 (
B
= 3.417,
P
= 0.027); the ideal mediolateral angle was significantly associated with BMI (
B
= 0.264,
P
= 0.031), sagittal diameter of C1 (
B
= − 4.559,
P
= 0.002), and pedicle height (
B
= − 2.317,
P
< 0.001); the distance between the IP and inferior aspects of posterior arch was significantly associated with age (
B
= − 0.002,
P
= 0.035), BMI (
B
= − 0.007,
P
= 0.028), sagittal length of posterior arch (
B
= − 0.187,
P
= 0.032), pedicle height (
B
= − 0.392,
P
< 0.001), and middle and lower parts of posterior arch (
B
= 0.862,
P
< 0.001).
Conclusion
The incidence of posterior arch variation in BI patients without AO was remarkably higher than that in control patients. The insertion parameters of posterior screws were different between the morphological classification types in BI and control groups. The distance between VA V3 segments and VAG in BI cohort was substantially smaller than that in control cohort. Preoperative individual 3D computed tomography (CT), CT angiography and intraoperative navigation are recommended for BI patients receiving posterior screw placement.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37530951</pmid><doi>10.1007/s00586-023-07873-4</doi><tpages>14</tpages><orcidid>https://orcid.org/0009-0004-7733-0304</orcidid><orcidid>https://orcid.org/0000-0002-2309-2855</orcidid><orcidid>https://orcid.org/0000-0002-1519-9919</orcidid><orcidid>https://orcid.org/0000-0001-5282-769X</orcidid><orcidid>https://orcid.org/0000-0002-4269-5520</orcidid><orcidid>https://orcid.org/0000-0002-9835-6384</orcidid><orcidid>https://orcid.org/0000-0002-7203-5769</orcidid><orcidid>https://orcid.org/0000-0003-4922-9255</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0940-6719 |
| ispartof | European spine journal, 2023-10, Vol.32 (10), p.3547-3560 |
| issn | 0940-6719 1432-0932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2845105373 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Angiography Atlanto-Axial Joint - surgery Bone Screws Classification Computed tomography Computed Tomography Angiography Humans Medicine Medicine & Public Health Morphology Neurosurgery Original Article Physical characteristics Platybasia Regression analysis Spinal Fusion - methods Surgical Orthopedics Tomography, X-Ray Computed Variation Vertebrae |
| title | Characteristics and evaluation of C1 posterior arch variation for transpedicular screw placement between patients with and without basilar invagination |
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