• Qi Liu, Wei Ji, Zhou Yang, Junyu Lin, Yapu Liu, Zucheng Huang, Junhao Liu, and Hui Jiang.
• Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
• World Neurosurg. 2020 May 1; 137: e152-e158.

ObjectiveThe feasibility of anterior transarticular crossing screws (ATCS) was confirmed in cadaveric specimens and it has been used in clinic. However, no study has documented the morphometric characteristics of ATCS. This study seeks to determine the morphometric characteristics of ATCS in C1-C2 fixation.MethodsA total of 100 patients without abnormality of C1-2 were enrolled. The range of screw lateral angles (LAs) and the screw lengths of ATCS on coronal images were measured on multiplanar computed tomography images, as well as the screw incline angles (IAs) in the sagittal plane. The ideal trajectory was designed as toward to the posterosuperior points of the opposite C1 lateral mass, which had the longest screw.ResultsThe LAs were relatively small in men (31.4°-45.3°) compared with women (32.6°-46.0°). In the sagittal plane, the IAs were ranged from 41.0° to 68.4° in men and from 44.4° to 68.1° in women. The overall screw lengths were longer in men (34.7-44.8 mm) than in women (32.2-39.6 mm). In the ideal path, the LA and IA were 38.4° and 41.0° in men and 39.6° and 44.4° in women, and the screw lengths were 44.8 mm in men and 39.6 mm in women.ConclusionsThis study provides the range of screw angles and lengths of ATCS, which will help surgeons to perform ATCS safely and accurately.Copyright © 2020 Elsevier Inc. All rights reserved.

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