title: The study on comparison of 3 techniques for transarticular screw placement in the lower cervical spine.
abstract: METHODS
  Prospective comparative study.
  
  
  OBJECTIVE
  To compare 3 techniques for transarticular screw placement in the lower cervical spine.
  
  
  BACKGROUND
  The transarticular screw is found to have satisfactory biomechanical stability. According to current studies, there are several techniques for the placement of transarticular screws in the lower cervical spine. Although several techniques are available for transarticular screw implantation in the lower cervical spine, only a few studies in the literature have been carried out to compare these techniques.
  
  
  METHODS
  The techniques of transarticular screw placement used by Takayasu (group A), Dalcanto (group B), and Klekamp (group C) were applied in 24 cervical specimens. The facet fractures, the encroachment of the cervical anterior branches of nerve roots and vertebral arteries and the failure of the screws to go through the facets were observed and analyzed.
  
  
  RESULTS
  One hundred ninety-two transarticular screws were implanted on both sides in 24 cervical cadavers, 64 for each group. There were 25 splits of inferior facets in group B, 2 splits in group C, and none in group A. Thirty-six screws encroached the vertebral arteries in group A, none in groups B and C. Forty anterior branches of lower cervical nerve roots were involved in group A, 5 in group B, and 3 in group C. Although all screws went through facets in the study except for 5 in group A, there were no significant differences between each group (χ(AB)2 = 3.33, P > 0.05; χ(AC)2 = 3.33, P > 0.05).
  
  
  CONCLUSIONS
  There is a high risk of injury to the anterior branch of the cervical nerve roots and vertebral artery if the screws were too long, and the Takayasu technique was used. However, the rate of facet splitting is high if the Dalcanto technique was applied. Klekamp's technique is recommended.
authors.affiliation: Department of Orthopedics, The Sixth Hospital of Ningbo, Ningbo, People's Republic of China. zhaoliujun555@sina.com
authors.forename: Liujun
authors.initials: L
authors.lastname: Zhao
authors.forename: Rongming
authors.initials: R
authors.lastname: Xu
authors.forename: Jiayong
authors.initials: J
authors.lastname: Liu
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Sochacki
authors.forename: Weihu
authors.initials: W
authors.lastname: Ma
authors.forename: Weiyu
authors.initials: W
authors.lastname: Jiang
authors.forename: Guanyi
authors.initials: G
authors.lastname: Liu
authors.forename: Jin
authors.initials: J
authors.lastname: Cao
authors.forename: Qun
authors.initials: Q
authors.lastname: Hua
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D021801:Zygapophyseal Joint / Q000601:surgery*