[Analysis of veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation].
OBJECTIVE
To evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding.


METHODS
In the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass).


RESULTS
Among the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation.


CONCLUSIONS
Probing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.
Department of Orthopaedics, Third Hospital of Peking University, Beijing 100083, China. wangmumu@medmail.com.cn
Sheng-Lin
SL
Wang
Chao
C
Wang
Ming
M
Yan
Hai-Tao
HT
Zhou
Geng-Ting
GT
Dang
D000293:Adolescent; D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000601:surgery; D001863:Bone Screws; D001270:Cervical Atlas / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods