title: An RCT study on the feasibility of anterior transpedicular screw fixation in the cervicothoracic junction.
abstract: We evaluated the trajectory and the entry points of anterior transpedicular screws (ATPS) in the cervicothoracic junction (CTJ).
  
  
  
  This study aimed at investigating the feasibility of ATPS fixation in the CTJ. Application of an ATPS in the lower cervical spine has been reported; however, there were no reports exploring the feasibility of anterior transpedicular screw fixation in the CTJ.
  
  
  
  CT scans were performed in 50 cases and multiplanar reformation was used to measure the related parameters on pedicle axis view at C6-T2. Transverse pedicle angle, outer pedicle width, pedicle axis length, distance transverse intersection point (DtIP), sagittal pedicle angle, anterior vertebral body height, outer pedicle height, and distance sagittal intersection point (DsIP) were measured. The prozone of CTJ was divided into three different regions, which were named as the "manubrium region", the region "above" and "below" the manubrium. The distribution of the trajectory of sagittal pedicle axes was recorded in the three regions and the related data were statistically analyzed.
  
  
  
  There was no statistical difference in gender (P > 0.05). The transverse pedicle angle decreased from C6 (46.77° ± 2.72°) to T2 (20.62° ± 5.04°). DtIP increased from C6 to T2. DsIP was an average of 7.17 mm. The sagittal pedicle axis lines of the C6 and C7 were located in the region above the manubrium. T1 was mainly in the manubrium region followed by the region above the manubrium. T2 was mainly located in the manubrium region followed by the region below the manubrium.
  
  
  
  Implantation of ATPS at C6, C7, and some T1 is feasible through the low anterior cervical approach, while it is almost impossible to approach T2 that way.
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China. zhaoliujun555@sina.com.cn.
authors.forename: Liujun
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Jinjiong
authors.initials: J
authors.lastname: Hong
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614, USA.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Wandtke
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Rongming
authors.initials: R
authors.lastname: Xu
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Weihu
authors.initials: W
authors.lastname: Ma
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Weiyu
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Jianqing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Ningbo 6th Hospital, Ningbo University, 1059#, Zhongshan Dong Road, Ningbo, Zhejiang, People's Republic of China.
authors.forename: Liran
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614, USA.
authors.forename: Jiayong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614, USA.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D065289:Pedicle Screws; D013904:Thoracic Vertebrae / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Anterior approach; Cervicothoracic junction; Pedicle screw; Spiral computed; Tomography