The spine journal : official journal of the North American Spine Society
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There have been several reports describing the usage of subaxial cervical laminar screws. However, the anatomic feasibility of placing such screws has not been thoroughly evaluated yet. ⋯ The relatively high success rate at C7, particularly of unilateral placement, suggests that laminar screw placement can be a sound alternative method for fixation at this level. However, careful preoperative CT scan evaluation and patient selection are required, particularly for bilateral fixation in women. At C3 and C6, unilateral screw placement can be considered in approximately 30% of patients after careful selection using preoperative CT scans. At C4 and C5, neither unilateral nor bilateral screw fixation is recommended for most patients.