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Updated: Nov 11, 2025
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C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
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Computed tomography comparison study of two Axis-based C1 transpedicular screw trajectory designs
Hongwei He1, Baiwen Hu2, Pengchao Cai3
1Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Medical Imaging Department, Ningbo First Hospital, Ningbo, China.
Summary
This study compared two C1 transpedicular screw trajectory designs, finding Axis C to be a reliable option. Individual patient anatomy dictates the optimal screw trajectory, which is typically medial.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Anatomy
Background:
- No prior studies have compared different Axis-based C1 transpedicular screw trajectory (TST) designs.
- C1 TST is crucial for atlantoaxial instability treatment.
Purpose of the Study:
- To compare the morphologic characteristics of two distinct Axis-based C1 TST designs.
Main Methods:
- Computed tomography (CT) angiography data from 62 patients were used.
- Multiplanar reconstruction (MPR) technique defined central axes (Axis M and Axis C) for C1 TST.
- Key parameters including insertion point distances, angles, and inner medullary cavity width were measured.
Main Results:
- Axis C trajectory design was found to be easier than Axis M.
- Measurements showed comparable distances and angles between the two designs.
- Axis C was achievable with medial, perpendicular, or lateral inclination in 81.5%, 13.7%, and 4.8% of sides, respectively; Axis M in 90.3%, 8.9%, and 0.8%.
Conclusions:
- Axis C represents a reliable trajectory for C1 transpedicular screw insertion, provided no C1 pedicle or lateral mass fracture.
- Individual anatomical variations necessitate adaptable TST approaches, with medial inclination being most common.
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