Related Experiment Video
Updated: Jun 4, 2026
12:25
C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
Posterior C2 instrumentation: accuracy and complications associated with four techniques
Richard J Bransford1, Anthony J Russo, Mark Freeborn
1Department of Orthopaedics and Sports Medicine, Harborview Medical Center/University of Washington Medical Center, Seattle, WA, USA. rbransfo@uw.edu
Spine
|February 4, 2011
Summary
Posterior C2 screw placement demonstrates high accuracy and a low complication rate, with anatomical variations influencing surgical technique. This study evaluates screw accuracy and safety in C2 instrumentation.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Instrumentation
Background:
- Cervical spine (C2) anatomy presents challenges for instrumentation due to its variability.
- Potential for severe complications exists with C2 instrumentation.
- Advancements in surgical techniques offer expanded options for C2 fixation.
Purpose of the Study:
- To evaluate the accuracy of posterior C2 screws using computed tomography (CT) scans.
- To assess the dimensions of "safe bony windows" for C2 screw placement via CT.
- To determine the perioperative complication rate associated with inaccurate C2 screw placement.
Main Methods:
- Retrospective review of a tertiary care spine database (January 2001-September 2008).
- Inclusion of patients with C2 instrumentation.
- Radiographic analysis using preoperative and postoperative CT scans to assess screw accuracy and bony dimensions.
Main Results:
- Analysis of 633 screws in 328 patients (339 pedicle, 154 transarticular, 63 laminar, 77 pars screws).
- High accuracy rates for pedicle (98.8%), transarticular (98.5%), laminar (100%), and pars screws (94.6%).
- Low incidence of unacceptable screw placement (8/509), with no neurologic injuries reported. Significant differences in bony dimensions noted between male and female patients.
Conclusions:
- Posterior C2 screw placement exhibits a lower complication rate than previously reported.
- Available posterior C2 fixation techniques provide flexibility for optimal surgical strategy.
- Understanding anatomical variations is crucial for safe and effective C2 instrumentation.
