Journal of neurosurgery. Spine
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OBJECT The purpose of this retrospective study was to quantify the anatomical relationship between the vertebral artery (VA), the cervical pedicle, and its surrounding structures, including the incidence of irregularities. Additionally, data delineating a "safe zone," and these data's application during instrumentation with transpedicular cervical screw fixation were considered. The anatomical proximity of the VA to the cervical pedicle prevents spine surgeons from preferring cervical pedicle screws (CPSs) over lateral mass screws at levels C3-6. ⋯ Pedicle diameter, safe zone, and occupational ratio of the VA in the foramen determine the risk associated with instrumentation and should be assessed individually. Based on the authors' measurements, C-4 and C-7 can be considered critical levels for CPS placement. Because of this and the high incidence of irregular VA pathways and different entry points, it may be helpful to review neck CT angiography studies before considering posterior instrumentation procedures in the cervical spine.
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OBJECT The objective of this work was to search a national health care database of patients diagnosed with cervical spine fractures in the US to analyze discharge, demographic, and hospital charge trends over a 10-year period. METHODS Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 1997 through 2006. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. ⋯ CONCLUSIONS During the studied period, increases in hospitalizations and charges were observed in both the SCI and non-SCI groups. The percentage increase was higher in the non-SCI group. Although SCI was associated with higher adverse outcomes, there were no significant improvements in immediate discharge status in either group during the 10 years analyzed.