Occipital condyle screw placement and occipitocervical instrumentation using three-dimensional image-guided...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Occipital condyle (OC) screws offer an alternative fixation point for occipitocervical fusion.
• Anatomical understanding of the craniocervical junction is crucial for safe screw placement.
• Previous literature has described safe placement techniques for occipital, C1 lateral mass, and C2 pars screws, but not OC screws.

Observation:

• Three-dimensional (3D) image-guided navigation was utilized in six patients undergoing occipitocervical fusion.
• The study focused on the technical aspects of placing OC screws and C1 lateral mass screws.
• Patient positioning and the StealthStation® S7™ image-guided navigational platform were key considerations.

Findings:

• Twelve OC screws were placed without any complications related to image-guided navigation.
• 3D image-guided navigation was found to be a valuable adjunct for placing OC screws.
• Minimizing intersegmental movement by delaying OC screw drilling until other screws are placed is recommended.

Implications:

• 3D image-guided navigation can be safely and effectively employed for the placement of instrumentation in the upper cervical spine, including OC screws.
• This technique enhances the safety and precision of occipitocervical fusion procedures.
• Further research may explore broader applications of image-guided navigation in complex spinal surgeries.