Vertebral Lateral Notch as Optimal Entry Point for Lateral Mass Screwing Using Modified Roy-Camille Technique

Norio Yamamoto; Hirofumi Kosaka; Kosaku Higashino; Masatoshi Morimoto; Kazuta Yamashita; Fumitake Tezuka; Fumio Hayashi; Yoichiro Takata; Toshinori Sakai; Akihiro Nagamachi; Koichi Sairyo

doi:10.4184/asj.2018.12.2.272

Asian Spine Journal (Apr 2018)

Vertebral Lateral Notch as Optimal Entry Point for Lateral Mass Screwing Using Modified Roy-Camille Technique

Norio Yamamoto,
Hirofumi Kosaka,
Kosaku Higashino,
Masatoshi Morimoto,
Kazuta Yamashita,
Fumitake Tezuka,
Fumio Hayashi,
Yoichiro Takata,
Toshinori Sakai,
Akihiro Nagamachi,
Koichi Sairyo

Affiliations

Norio Yamamoto: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Hirofumi Kosaka: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Kosaku Higashino: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Masatoshi Morimoto: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Kazuta Yamashita: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Fumitake Tezuka: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Fumio Hayashi: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Yoichiro Takata: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Toshinori Sakai: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Akihiro Nagamachi: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
Koichi Sairyo: Department of Orthopedics, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.

DOI: https://doi.org/10.4184/asj.2018.12.2.272
Journal volume & issue: Vol. 12, no. 2
pp. 272 – 276

Abstract

Read online

Study DesignRetrospective study of 37 consecutive female patients with cervical spondylotic myelopathy who underwent reconstructed computed tomography (CT) scanning of the cervical spine.PurposeThe purpose of this study was to investigate whether the vertebral lateral notch of the cervical spine is an effective landmark to determine the entry point for lateral mass screwing. A modified Roy-Camille technique was used to determine the entry point associated with the lateral notch of the cervical spine.Overview of LiteratureThe Roy-Camille technique has been a popular technique for the posterior fixation of the cervical spine. A problem with this technique is determining the entry point on the lateral mass via visual inspection, such as in cases with degenerative or destructive cervical facet joints.MethodsThirty-three female patients with cervical spondylotic myelopathy underwent reconstructed CT scanning of the cervical spine. Overall, 132 vertebrae from C3 to C6 were reviewed using reconstructed CT. The probable trajectory using a modified Roy-Camille technique was determined using reconstructed CT scans, and the optimal entry point was identified. Horizontal and vertical distances from the vertebral lateral notch were measured.ResultsThe entry point determined using the modified Roy-Camille technique was significantly superior and medial compared with that determined using the conventional Roy-Camille technique. At C3 and C4 levels, the entry point using the modified technique was 1.4 mm below and 4.4 mm medial to the lateral notch, and at C5 and C6 levels, it was 2.3 mm below and 4.9 mm medial to the lateral notch.ConclusionsThe vertebral lateral notch of the cervical spine was an effective landmark to determine the entry point for lateral mass screwing. The modified Roy-Camille technique proposed here may prevent surgical complications and poor outcomes.

Published in Asian Spine Journal

ISSN: 1976-1902 (Print); 1976-7846 (Online)
Publisher: Korean Spine Society
Country of publisher: Korea, Republic of
LCC subjects: Medicine
Website: https://asianspinejournal.org/

About the journal

Abstract

Keywords