The location of the pedicle and pars interarticularis in the axis.

STUDY DESIGN: This is an anatomic and radiologic study on the lateral mass of the C2 vertebra. OBJECTIVES: To define the location of the pedicle and pars interarticularis in the C2 vertebra. SUMMARY OF BACKGROUND DATA: Transpedicular screw fixation of the C2 has been addressed in the literature. However, the use of the anatomic terminology of the pedicle or pars interarticularis (isthmus) in C2 is confusing in most of orthopaedic and neurosurgical literature since C2 is considered a transitional vertebra. METHODS: Twenty dry C2 vertebrae were obtained for observation of the external anatomy of the C2 from superior, lateral, and inferior views. Six C2 vertebrae were harvested from cadavers and sectioned in the sagittal, horizontal, and coronal planes to observe the internal structures of the lateral mass using high resolution radiographs. RESULTS: Based on observation, the pedicle of the C2 vertebra is defined as the portion beneath the superior facet and anteromedial to the transverse foramen. The pars interarticularis or isthmus is defined as the narrower portion between the superior and inferior facets. No remarkable difference in bone density and trabecular bone orientation between the pedicle and pars interarticularis was noted. CONCLUSIONS: It is still more appropriate to call this procedure "transpedicular screw fixation" in the C2 to avoid confusion, although this technique requires placing a screw from the posterior aspect of the inferior articular process through the isthmus and pedicle into the vertebral body.

The vertebral body depths of the cervical spine and its relation to anterior plate-screw fixation.

STUDY DESIGN: A study was performed to measure the vertebral body depths in different locations from C2 to C7. OBJECTIVES: To measure the vertebral body depths in 10 linear dimension from C2 to C7. SUMMARY OF BACKGROUND DATA: Anterior plate-screw fixation of the cervical spine has been the common surgical procedure for management of multilevel degenerative disc disease and fracture dislocation. However, injury to the spinal cord during drill or screw placement is the most feared complication of this procedure. It is beneficial for one to have a knowledge of the vertebral body depths in different locations of the vertebral body before anterior cervical plating. METHODS: Twenty-seven cervical spines from C2 to C7 were evaluated directly for this study. Anatomic evaluation of the vertebral body included the anteroposterior midline sagittal depth and the anteroposterior parasagittal depth 5 mm lateral to midline on the superior and inferior endplates, as well as on the middle body. Measurements also were made of anteroposterior parasagittal vertebral depth with both medial and lateral inclination of 10 degrees, with respect to the parasagittal plane of the vertebral body. RESULTS: In general, the measurements of male specimens were larger than those of female specimens. Significant differences were noted at 21 measurements over C3 through C7. The mean depths of the superior endplate for all male and female specimens increased consistently from C3 to C7. The mean depths of the inferior endplate varied but generally increased from C2 to C6, then decreased to C7. The mean sagittal and parasagittal middle vertebral body depths were both 14 mm. CONCLUSIONS: This information, in conjunction with preoperative computed tomographic evaluation, may be helpful in determining proper screw length during anterior plating of the cervical spine.

Mechanisms of angiotensin-induced hypotension and bradycardia in the medial solitary tract nucleus.

The selective angiotensin (ANG) II antagonists losartan (AT1) and CGP-42112A (AT2) were used to determine the receptor subtype and neuronal pathways that mediate the hypotension and bradycardia produced by 200 fmol of ANG II microinjected into the dorsal medial nucleus tractus solitarii (NTS) or dorsal motor nucleus of the vagus (dmnX) in anesthetized rats. At dorsal medial NTS sites (0.3 mm below the surface) where L-glutamate microinjections produced maximal decreases in mean arterial pressure (MAP) and heart rate (HR), ANG II (200 fmol, 50 nl, n = 16) elicited hypotension (-22 +/- 1 mmHg) and bradycardia (-26 +/- 2 beats/min). Although L-glutamate also suppressed respiration, ANG II injections in the medial NTS did not alter respiration. Losartan injected at the medial NTS site caused a dose-dependent reduction of ANG II-induced decreases in MAP and HR. At 2 pmol, the AT1 antagonist attenuated the response to ANG II, whereas 100 pmol abolished the effects of ANG II microinjections. In contrast, the AT2 antagonist CGP-42112A (100 pmol) had no effect on the responses to ANG II. Neither ANG II antagonist altered the cardiovascular effects of L-glutamate injections. Losartan injected into the dmnX blocked hypotension and bradycardia produced by ANG II at that site but did not prevent responses to subsequent ANG II injections in the medial NTS.(ABSTRACT TRUNCATED AT 250 WORDS)