Related Experiment Videos
Finding the "Sweet Spot" for C2 Root Transection in C1 Lateral Mass Exposure
William Clifton1, Steve Edwards1, Conrad Dove2
1Department of Neurological Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA.
World Neurosurgery
|April 6, 2019
Summary
Identifying the ideal C2 nerve transection point during atlantoaxial fusion is crucial. This study found the medial border of the lateral mass is a reliable landmark for safe C2 nerve sectioning.
Area of Science:
- Neurosurgery
- Spine Anatomy
- Surgical Technique
Background:
- Atlantoaxial fusion often necessitates C2 nerve transection for adequate C1 lateral mass exposure.
- Transection proximal to the dorsal root ganglion minimizes postoperative dysesthesias.
- Proximal transection risks dura violation and cerebrospinal fluid leaks.
Purpose of the Study:
- Quantify the C2 nerve preganglionic segment length in cadavers.
- Develop a reliable intraoperative method for C2 nerve sectioning during C1-2 arthrodesis.
Main Methods:
- Microsurgical dissection of 16 C2 nerves from 8 cadaveric cervical spine specimens.
- Measurement of key parameters to identify the preganglionic segment.
- Determination of the "sweet spot" for transection at the midpoint of the preganglionic segment.
Main Results:
- The ideal C2 nerve transection point was determined to be 3 mm lateral to the medial border of the lateral mass.
- Remarkable consistency was observed in the preganglionic segment length across specimens.
Conclusions:
- The medial border of the lateral mass serves as a reliable anatomical landmark for identifying the C2 nerve's preganglionic segment.
- Intraoperative use of this landmark optimizes safety during atlantoaxial fixation, minimizing complications and improving patient outcomes.