Three-dimensional quantitative CT analysis of the C2 spinous process and its implications for spinous process screw...

Area of Science:

• Orthopedic surgery
• Neurosurgery
• Anatomy

Background:

• Cervical spine fixation is crucial for stability.
• Conventional C2 fixation methods may not always be feasible.
• The C2 spinous process presents a potential fixation site.

Purpose of the Study:

• To conduct a 3D quantitative CT analysis of the C2 spinous process.
• To compare the morphometric feasibility of vertical, horizontal, and oblique screw trajectories for C2 spinous process fixation.
• To guide clinical applications for C2 fixation when conventional methods fail.

Main Methods:

• Retrospective analysis of CT data from 100 adults.
• 3D reconstructions of the C2 vertebra using 3D Slicer.
• Measurement of C2 spinous process morphometrics (height, width).
• Virtual simulation and insertion of screw trajectories (vertical, horizontal, oblique) using AutoCAD and 3D Slicer.
• Analysis of gender differences and age correlations.

Main Results:

• Mean C2 spinous process height was 10.50 mm, decreasing from base to tip.
• Spinous process width increased caudally, with males having greater width than females.
• Horizontal trajectories offered the longest screw path (20.65 mm), followed by oblique (17.70 mm) and vertical (14.79 mm).
• No significant correlation between morphometric parameters and age.

Conclusions:

• The C2 spinous process has sufficient dimensions for screw fixation.
• Horizontal and oblique screw trajectories provide longer and potentially more stable fixation.
• These trajectories are viable alternatives for salvage or supplementary C2 fixation.