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J Spinal Disord Tech · Apr 2011
Comparative StudyComparison of two techniques for transarticular screw implantation in the subaxial cervical spine.
- Liujun Zhao, Rongming Xu, Jiayong Liu, Joseph Konrad, Weihu Ma, Weiyu Jiang, Ming Li, Huajie Xia, Qun Hua, and Guoping Wang.
- Department of Orthopaedic Surgery and Radiology, NingBo 6th hospital, NingBo, ZheJiang, People's Republic of China. zhaoliujun555@sina.com.cn
- J Spinal Disord Tech. 2011 Apr 1;24(2):126-31.
Study DesignCross-sectional study.ObjectiveTo compare 2 techniques of transarticular screw placement in the subaxial cervical spine.Summary Of Background DataTransarticular screws have been used as an alternative method to achieve posterior cervical spine stability. According to current studies there are several techniques for the placement of transarticular screws in the subaxial cervical spine; however, there is no study that has compared these techniques.MethodsThe techniques of transarticular screw placement by Takayasu (group A) and Dalcanto (group B) were used in 8 cervical specimens. The position, number of facet fractures, involvement of the vertebral artery, encroachment of the anterior branches of cervical nerve roots, and instances that failed to go through the facets were observed and analyzed.ResultsSixty-four screws were implanted, 32 for group A and the same for group B. Although no facet fractures were seen in group A, there were 10 in group B (χ=9.6, P<0.01). Eight screws involved the vertebral artery in group A and 0 in group B (χ=22.3, P<0.001). Eleven anterior branches of lower cervical nerve roots were encroached in group A and 2 in group B (χ=22.0, P<0.001). No screws failed to go through the facets in group B whereas 2 screws failed in group A, resulting in no significant difference (χ=0.52, P>0.05).ConclusionsThere was a high risk of injury to the vertebral artery and anterior branches of the cervical nerve roots if the screws were too long and Takayasu technique was used. However, more facets were fractured if Dalcanto technique was applied.
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