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Can Axis C be a navigation route - CT comparison study between actual and virtual C1 transpedicular screw insertion
1Medical Imaging Department, Ningbo First Hospital, Ningbo, China; Medical Imaging Department, First Affiliated Hospital of Ningbo University, Ningbo, China.
Summary
Axis C offers an ideal trajectory for C1 transpedicular screw insertion (TSI), significantly reducing cortical perforation risks compared to traditional methods. This finding supports its use in computer-assisted surgery for enhanced safety.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Anatomy
Background:
- Traditional C1 transpedicular screw insertion (TSI) primarily utilized perpendicular and medial inclination techniques.
- Recent research identified medial, perpendicular, and lateral inclinations, including Axis C, as viable C1 transpedicular screw trajectories (TST).
Purpose of the Study:
- To validate Axis C as an optimal C1 TST by comparing cortical perforation rates between actual C1 TSI and virtual C1 TSI along Axis C.
Main Methods:
- Postoperative CT scans of 12 patients assessed cortical perforations from actual C1 TSI in the transverse foramen and vertebral canal.
- Virtual C1 TSI along Axis C was simulated using preoperative CT data from the same patients.
- Cortical perforation differences between actual and virtual screw insertions were analyzed.
Main Results:
- Actual C1 TSI resulted in a 54.2% cortical perforation rate (13/24 sides), involving the transverse foramen (5 sides) and vertebral canal (8 sides).
- Perforations were predominantly mild (12 locations) with one medium-grade perforation.
- No cortical perforations occurred in the Virtual C1 Axis C TSI group.
Conclusions:
- Axis C represents an ideal trajectory for C1 TSI, demonstrating superior safety by eliminating cortical perforations.
- This trajectory can be effectively integrated into computer-assisted surgery systems for navigation.
