Abstract

Posterior occipitocervical or atlantoaxial fixation and fusion procedures using C2 pedicle or short par or laminar screws instrumentation is widely used to treat patients with atlantoaxial dislocation or instability.

Highlights

  • Posterior occipitocervical or atlantoaxial fixation and fusion procedures using C2 pedicle or short par or laminar screws instrumentation is widely used to treat patients with atlantoaxial dislocation or instability [1-4]

  • We are aware preoperative imaging evaluation with computed tomography (CT) sagittal reconstruction, axial scan and CT angiography can allow a better understanding of the vertebral artery variations [13,14]

  • Given the limitations of the studies, the primary purpose was to illustrate the anatomic risk of VA groove violation by computed tomography (CT) scan images to protect those with a high-riding vertebral artery and help to design treatment strategy

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Summary

Introduction

Posterior occipitocervical or atlantoaxial fixation and fusion procedures using C2 pedicle or short par or laminar screws instrumentation is widely used to treat patients with atlantoaxial dislocation or instability [1-4]. As injury rate of vertebral artery has been reported to be as high as 8.2% [1], the presence of an anomalous artery in patients increases the risk of jeopardizing it in operation [2-5]. Anatomical studies of the atlantoaxial region reported up to 5% anomalous vertebral artery (VA) and 18% high-riding transverse foramen [8]. We are aware preoperative imaging evaluation with CT sagittal reconstruction, axial scan and CT angiography can allow a better understanding of the vertebral artery variations [13,14]. Given the limitations of the studies, the primary purpose was to illustrate the anatomic risk of VA groove violation by computed tomography (CT) scan images to protect those with a high-riding vertebral artery and help to design treatment strategy

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