International Journal of General Medicine (Sep 2021)
The Feasibility of Anterior Occipital Condyle Screw for the Reconstruction of Craniovertebral Junction: A Digital Anatomical and Cadaveric Study of a Novel Technique
Abstract
Dingli Xu, 1 Yujie Peng, 2 Haojie Li, 2 Yang Wang, 2 Weihu Ma 2 1Department of Orthopedics, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 2Department of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Weihu MaDepartment of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People’s Republic of ChinaEmail [email protected]: Anterior occipital condyle screw (AOCS) could be a feasible alternative technique for occipitocervical fusion for reconstruction of craniovertebral junction. This study aimed to analyze the feasibility of AOCS.Methods: The craniovertebral junction computed tomography (CT) scans of 40 adults were enrolled and imported into Mimics software. Then, the three-dimensional reconstruction digital model of craniovertebral junction was established to determine entry point, insertion angle, and screw’s trajectory. After AOCS insertion into ten human cadaver spine specimens, CT scans were performed to verify the location between screws and important structures.Results: The optimal entry point was located caudally and medial to the ventral of occipital condyle. The optimal trajectory was in inclination angle (5.9°± 3.4°) in the sagittal plane and divergence angle (26.7°± 6.0°) in the axial plane with the screw length around 21.6± 1.2mm. None of the screws invaded the hypoglossal canal and vertebral artery in any of the specimens.Conclusion: AOCS fixation is a feasible, novel technique for anterior craniovertebral junction reconstruction, and it could be an effective alternative operation for anterior reconstruction with titanium mesh cage.Keywords: anterior occipital condyle screw, craniovertebral reconstruction, optimal trajectory, cadaveric study
