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Variation of the groove in the axis vertebra for the vertebral artery

IMPLICATIONS FOR INSTRUMENTATION

Transarticular screws at the C1 to C2 level of the cervical spine provide rigid fixation, but there is a danger of injury to a vertebral artery. The risk is related to the technical skill of the surgeon and to variations in local anatomy.

We studied the grooves for the vertebral artery in 50 dry specimens of the second cervical vertebra (C2). They were often asymmetrical, and in 11 specimens one of the grooves was deep enough to reduce the internal height of the lateral mass at the point of fixation to <=2.1 mm, and the width of the pedicle on the inferior surface of C2 to <=2 mm. In such specimens, the placement of a transarticular screw would put ...

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