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Related Experiment Video

Updated: Jun 16, 2026

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

Published on: January 6, 2023

Morphometric trajectory analysis for the C2 crossing laminar screw technique.

Bin Yue¹, Dai-Soon Kwak, Moon-Kyu Kim

¹Department of Spine Surgery, Affiliated Hospital of Qingdao University Medical College, Qingdao, China.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|February 23, 2010

Summary

This study identifies the optimal entry point for C2 crossing laminar screws, enhancing surgical safety. The ideal zone offers maximal screw pass ratio, safe angle range, and screw length for precise placement.

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Area of Science:

Neurosurgery
Orthopedic Surgery
Anatomy

Background:

Safe C2 crossing laminar screw placement requires a validated trajectory.
Existing techniques lack comprehensive morphometric analysis to confirm screw trajectory accuracy.

Purpose of the Study:

To provide quantitative anatomical data for safe C2 crossing laminar screw placement.
To identify the optimal entry point and trajectory for C2 crossing laminar screws.

Main Methods:

Morphometric analysis of 100 Korean C2 3D CT reconstructions.
Simulated placement of 3.5 mm diameter crossing laminar screws from 1 mm zoned trajectories.
Measurement of screw pass ratio (PR), safe screw angle range (SAR), and maximum screw length (MSL).

Main Results:

The zone 5-6 mm posterior to the spinal canal's post-edge is the safest entry point.
This optimal zone provides maximal PR (85%), SAR (9.57° ± 4.36°), and MSL (21.74 mm ± 2.44 mm).
Recommended axial plane safe screw angle is 49.68° ± 4.94° to 59.19° ± 4.70°, with individual variations noted.

Conclusions:

The posterior C2 laminar zone (5-6 mm) is recommended for safe crossing laminar screw placement.
Preoperative evaluation of screw trajectory is crucial for successful and safe screw insertion.
This morphometric data enhances the precision of C2 laminar screw fixation techniques.