ABSTRACT
Introduction: The Aim of the study was to provide the morphometric measurement of the axis vertebrae in North Indian popuulation. Which could be used as clinical tool to determine the feasibility of safe translaminar screw placement. Subjects and Methods: 50 dry human axis vertebrae from adult North Indian population were subjected to morphometric measurement using venier caliper. The various dimensions of the axis vertebrae were observed. Results: There is high variability in the thickness of the C2 lamina. As compared to western population, the axis bones used in the present study had smaller profiles. Conclusion: The current study showed safety margin for translaminar screw insertion is low.
ABSTRACT
Multiple techniques exist for the fixation of C2, including axial pedicle screws and bilateral translaminar screws. We describe a novel method of incorporating both the translaminar and pedicle screws within C2 to improve fixation to the subaxial spine in patients requiring posterior cervical instrumentation for deformity correction or instability. We report three cases of patients with cervical spinal instability, who underwent cervical spine instrumentation for stabilization and/or deformity correction. Bilateral C2 pedicle screws were inserted, followed by bilateral crossed laminar screws. The instrumentation method successfully achieved fixation in all three patients. There were no immediate postoperative complications, and hardware positioning was satisfactory. Instrumenting C2 with translaminar and pedicle screws is technically feasible, and it may improve fixation to the subaxial spine in patients with poor bone quality or severe subaxial deformity, which require a stronger instrumentation construct.